冠状动脉旁路移植术后严重神经系统并发症发生的危险因素*
Risk factors of severe neurological complications after coronary artery bypass graft

目的：探讨冠状动脉旁路移植术后严重神经系统并发症发生的危险因素。方法：收集1 060例冠状动脉旁路移植术后患者的资料，术后发生严重神经系统并发症57例，采用logistic回归对术后严重神经系统并发症发生的危险因素进行筛选。 结果：57例中，脑栓塞13例，颅内出血7例，连续昏迷17例，谵妄15例，癫痫2例，缺血性视神经脑病3例。57例中，11例死亡，46例存活。经logistic回归分析，年龄≥70岁是一个主要的危险因素［β=1.622，OR(95%CI)=5.063(1.085~46.165)］；术中体外循环对严重神经系统并发症的发生没有影响［β=0.910，OR(95%CI)=2.485(0.437~5.097)］。结论：年龄≥70岁为冠状动脉旁路移植术后严重神经系统疾病并发症发生的重要危险因素。
To investigate the risk factors of severe neurological complications after coronary artery bypass graft. Methods: A total of 1 060 patients underwent coronary artery bypass graft were collected and 57 cases occurred severe neurological complications. Logistic regression was used to screen risk factors for severe neurological complications after the surgery. Results: In the 57 cases, 13 cases were cerebral embolism, 7 cases were intracranial hemorrhage, 17 cases were consecutive coma, 15 cases were delirium, 2 cases were epilepsy, 3 cases were ischemic optic encephalopathy. In 57 cases, 11 died after the surgery, 46 cases survived. The results of logistic regression analysis showed that ≥70 years old was a significant risk factor［β=1.622，OR(95%CI)=5.063(1.085-46.165)］, while bypass during surgery was not significant［β=0.910，OR(95%CI)=2.485(0.437-5.097)］.Conclusion: Age ≥70 years is one of the most important risk factors for severe neurological complications after coronary artery bypass graft