摘要
目的 评价脑干听觉诱发电位 (BAEP)和血清神经元特异性烯醇化酶 (s NSE)在小儿先心病(CHD)心脏手术前后检测的意义。方法 1.测定体外循环开放式不停跳手术的CHD患儿 2 0例手术前后BAEP的变化 ;2 .测定心脏不停跳、停跳手术患儿各 2 0例术前 2 4h、术后 2h、7d的s NSE水平。结果 1.CHD患儿与对照组比较和手术前或后紫绀型先心病 (CCHD)和非紫绀型先心病 (NCCHD)比较 ,CCHD组Ⅲ Ⅴ、Ⅰ Ⅴ波和Ⅰ Ⅴ波峰间潜伏期 (IPL)显著延长 (P <0 .0 5 )。 2 .手术组术后 2h血s NSE水平显著增高 ,不停跳组和停跳组平均值与术前比较差异非常显著 (P <0 .0 0 1) ;术后 7ds NSE水平上述两组与术前比较差异显著 (P <0 .0 5 )。3.术后 2hs NSE水平停跳组明显高于不停跳组 (P <0 .0 0 1) ,且术后 7ds NSE水平两组比较差异显著 (P <0 .0 5 )。结论 1.CCHD可伴随脑功能损害 ;2 .s NSE的变化可提示体外循环手术过程中的脑功能受损 ;3.就脑保护而言 。
Objective To evaluate the value of brainstem auditory evoked potential(BAEP)and serum neuronal specific enolase (s NSE) during the heart surgery on the children with congenital heart disease(CHD) under extracoperal circulation.Methods 1.BAEPs were examined in 20 children with CHD before and after heart beating under extracorporeal circulation.2.The s NSE levels were detected in 20 of CHD operated under heart beating condition and others under heart arrested condition.Results Compared with normal children, Ⅲ Ⅴ and Ⅰ Ⅴ interpeak latencies (IPL)in CHD patients were significantly prolonged in cyanotic CHD (CCHD) (P<0.05).There was significant difference between CCHD and non cyanotic CHD( NCCHD) inⅠ Ⅴ IPL(P<0.05). The s NSE levels were elevated 2 hours after operation compared with those 24 hours before operation(P<0.001). There was significant difference in the average of s NSE compared with 24 hours before operation on the 7th day after operation(P<0.05). There was significant difference between heart beating group and heart arrested group in the average value of s NSE at 2 hours or 7 days after operation(P<0.001,P<0.05).Conclusions The CCHD might be complicated with the damage to the cerebral function .The changes of s NSE levels could indicate functional brain damage during the surgical procedures under extracorporeal circulation. The surgery in heart bea ting condition may be better than that in heart arrested condition as to protect the brain.
出处
《实用儿科临床杂志》
CAS
CSCD
北大核心
2002年第1期9-11,共3页
Journal of Applied Clinical Pediatrics
关键词
儿童
先天性心脏病
脑干听觉诱发电位
血清神经元特异性烯醇化酶
体外循环
children
congenital heart disease
brainstem auditory evoked potential
serum neuronal specific enolase
extracorporeal circulation
