心脏手术后精神障碍的临床分析

为研究心脏手术后精神障碍的病因、发病机理及防治措施，对２０５３例心脏手术病人进行了观察。结果显示，５４例病人出现精神障碍并发症，发生率为２．６３％；其中体外循环术后发生率为３．１２％，非体外循环术后发生率为１．４７％，两者间差异有显著性（Ｐ＜０．０５）。术前心功能状况较差者，更易出现精神障碍（Ｐ＜０．０１）。病人均为成年人，症状大多出现于２周以内，表现为躁狂状态、抑郁状态、精神分裂样状态及神经症性反应，经治疗后均痊愈。认为心脏术后精神障碍主要与精神因素、体外循环损伤、心功能状况、年龄等有关，强调精神因素所起的作用，提示应采取综合治疗及预防。

A clinical analysis of mental disorder after heart surgery

In order to assay the etiology, pathogenesis, prevention and treatment measures of postoperative psychosis after heart surgery, 2 053 subjects were observed. 54 of them developed psychiatric symptoms after heart surgery, with the incidence of mental disorder of 2.63%. The incidence of mental disorder in non cardiopulmonary bypass operations and cardiopulmonary bypass operations was 1.47% and 3.12% respectively, with a significant difference between these two subgroup ( P <0.01). All patients with postoperative psychosis were adults. The symptoms usually occurred within 2 weeks after operation, being as manic state, depressive state, schizophrenia like state and neurotic reaction. The symptoms were relieved with appropriate treatment. The result suggested that the occurrence of postoperative psychosis after heart surgery was mainly related to psychological factors, damage of bypass, severity of cardiac dysfunction and age of the patients. The psychological factors were important, and the comprehensive treatment and prevention measures were suggested