Funda YILDIRIM, Hayrettin ŞİRİN, İlhan İŞKESEN

Koroner arter bypass cerrahisinde kardiyopulmoner bypass’ın nörokognitif fonksiyonlara etkisi

Amaç: Koroner arter cerrahisi geçiren hastalarda kardiyopulmoner bypass uygulamasının nörokognitif fonksiyonlara etkisi değerlendirildi. Çalışma planı: Koroner arter bypass greft ameliyatı geçiren 36 hasta (24 kadın, 12 erkek; ort. yaş 57±2) ileriye dönük olarak çalışmaya alındı. Hastalara ameliyat öncesi ve ameliyat sonrası birinci ayda nörokognitif testler (Yaşam Kalitesi SF-36 testi, Standardize Mini- Mental Test, Hamilton Anksiyete Ölçeği, Pitsburg Uyku Kalite İndeksi ve Epworth Uykululuk Testi) uygulandı. Hastaların demografik ve hemodinamik özellikleri değerlendirildi.Bulgular: Ameliyat öncesi ve sonrası değerler karşılaştırıldığında, Yaşam Kalitesi SF-36 testi ve Hamilton Anksiyete Ölçeği’nde psikolojik ve motor ya da fiziksel fonksiyon altgruplarında ameliyattan sonra anlamlı artış görüldü (p0.05). Pittsburgh ve Epworth testlerinde ise sırasıyla anlamlı olmayan azalma ve artış görüldü.Sonuç: Koroner bypass cerrahisi hastaların yaşam kalitesini artırmaktadır. Hamilton motor ve psikolojik anksiyete değerlendirmesinde her iki parametrede azalma görülmüştür. Kognitif fonksiyonlarda düşüş anlamlı bulunmamıştır.

Neurocognitive effects of cardiopulmonary bypass in coronary artery bypass surgery

Background: We evaluated the effect of cardiopulmonary bypass on neurocognitive functions in patients undergoing coronary bypass surgery. Methods: This prospective study included 36 patients (24 women, 12 men; mean age 57±2 years) who underwent coronary artery bypass surgery. The patients were administered a neurocognitive test battery before and one month after surgery, including the Health-Related Quality of Life (SF-36), Standardized Mini-Mental State Examination, Hamilton Anxiety Scale, Pittsburgh Sleep Quality Index, and Epworth Sleepiness Scale. In addition, demographic data and hemodynamic parameters of the patients were evaluated.Results: Compared to the preoperative scores, significant improvements were found in the psychologic and motor or physical function subsets of the SF-36 and Hamilton Anxiety Scale after the operation (p0.05). There was a decrease in the Pittsburgh Sleep Quality Index and an increase in the Epworth Sleepiness Scale, but both did not reach a significant level.Conclusion: Coronary bypass surgery improves the patients’ quality of life, but it significantly decreases motor and psychologic parameters. Decrease in cognitive functions is not significant.

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