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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 ,心不停跳术式优于停跳术式
Objective To evaluate the significance of brainstem auditory evoked potentials (BAEP) and serum neuron specific enolase (s NSE) levels in children with congenital heart disease (CHD) before and after cardiac surgery. Methods 1. To determine the changes of BAEP in 20 CHD patients undergoing open loop beating surgery after cardiopulmonary bypass. 2. To determine the changes of BAEP before and after cardiopulmonary bypass. 2. , 7d’s NSE level. Compared with the control group and before and after CHD, the latency (IPL) of the wave of III Ⅴ, Ⅰ Ⅴ and Ⅰ Ⅴ waves in CCHD group was significantly higher than that in control group (CCHD) and non-cyanotic congenital heart disease (NCCHD) Significantly longer (P <0.05). The level of serum NSE in the operation group at 2h after operation was significantly higher than that in the non-stop group and the stop group (P <0.01) Preoperative difference was significant (P <0. 05). The levels of NSE in 2 h postoperatively in NSE group were significantly higher than those in non-stop group (P <0.01), and the levels of NSE in 7 days after operation were significantly different between the two groups (P <0.05). CCHD may be associated with impaired brain function.2. Changes in NSE may indicate impaired brain function during cardiopulmonary bypass surgery.3. In the case of brain protection, beating heart surgery is superior to stopping surgery