【摘要】 目的:研究分析肢体远隔缺血预处理对深低温停循环患者术后认知功能及肾损伤的影响。方法:选取2013年9月至2016年9月期间收治的100例Stanford A主动脉夹层患者作为研究对象,根据随机数表法分为观察组、对照组,各50例。对照组患者采用深低温停循环,观察组患者采用肢体远隔缺血预处理联合深低温停循环。观察并比较两组患者治疗前后认知功能及输血量、停循环时间。结果:术后两组患者认知功能MMSE评分均低于术前(P<0.05),但观察组高于对照组(P<0.05);观察组患者术中输血量、停循环时间均少于对照组(P<0.05)。结论:采用肢体远隔缺血预处理联合深低温停循环能有效缓解脑缺血、缺氧现象,减少脑损伤风险,缓解肾缺血状况,减少患者肾缺血性损伤风险,且对患者认知功能的影响较小,值得临床推广。更多还原

【Abstract】 Objective: To investigate the effect of remote ischemic preconditioning on cognitive function and renal injuries in patients with deep hypothermic circulatory arrest. Methods: 100 patients with Stanford A aortic dissection diagnosed and treated from September 2013 to September 2016 were selected as the subjects and divided into the study group and the control group,with 50 cases in each group according to the random number table method. The patients in the control group were treated with deep hypothermic circulatory arrest while the patients in the study group were treated with remote ischemic preconditioning combined with deep hypothermic circulatory arrest. The cognitive function,the amount of blood transfusion and the time of circulatory arrest were observed and compared between the two groups before and after treatment. Results: The MMSE scores of cognitive function after operation in the two groups were lower than those before operation,but those in the study group were higher than those of the control group and the difference was statistically significant( P < 0. 05). The amount of blood transfusion and the time of circulatory arrest of the patients in the study group were less than those in the control group and the difference was statistically significant( P < 0. 05). Conclusion: The remote limb ischemic preconditioning combined with deep hypothermic circulatory arrest can effectively alleviate cerebral ischemia and hypoxia,reduce the risk of brain damage,alleviate renal ischemia and reduce the risk of renal ischemic injury,and it has less influence on the cognitive function of the patients,which is worthy of promotion.更多还原