Objective To determine the effects of gastrodin on postoperative cognitive dysfunction(POCD) in patients undergo cardiopulmonary bypass. Methods A total of 120 patients, scheduled to undergo cardiopulmonary bypass for cardiac surgery, were randomly allocated to receive gastrodin(experiental group,n = 60) ,and saline(control group,n = 60). The incidence of POCD at pre-surgery, 3 days post-surgery, 7 days post-surgery, 10 weeks post-surgery and 6 months after surgery were assessed by MMSE. Mor-bidity and length of stay were recorded. Results The incidence of POCD at pre-surgery,3 days post-surgery, 7 days post-surgery, 10 weeks post-surgery and 6 months after surgery in experiental group was 26. 7 % , 11. 7 % , 5. 1 % , 1. 8 % , respectively. The inci-dence of POCD in control group was 45% , 20% , 7% , 1. 9%, respectively. The incidence of neurocognitive dysfunction at 3 days post-surgery was significantly lower for gastrodin compared with saline(P<0. 05). There were no differences in morbidity and length of stay. Conclusion Gastrodin may contribute to early cognitive recovery after open-heart surgery with cardiopulmonary bypass, but has no effect on the incidence of long-term POCD.%目的 研究天麻素注射液对体外循环下行心脏瓣膜置换术患者术后认知功能障碍(POCD)的影响.方法 拟择期全麻体外循环行二尖瓣置换术患者120例,随机分为实验组和对照组,两组分别于体外循环开始前10 min开始静脉滴注天麻素注射液600 mg(溶于250 mL生理盐水中)和250 mL生理盐水,并在阻断升主动脉前10 min输完.采用简易智能状态检查法(MMSE)进行术前,术后3 d、7 d、10周及6个月认知功能评估,并记录两组并发症发生率及住院时间等.结果 对照组术后3 d、7 d、10周及6个月随访POCD的发生率分别为45.0%、20.0%、7.0%、1.9%,实验组分别为26.7%、11.7%、5.1%、1.8%,术后3 d POCD的发生率实验组明显低于对照组(P＜0.05),术后7 d、10周、6个月POCD的发生率两组间比较差异无统计学意义(P＞0.05).两组术后机械通气时间、ICU停留及住院时间、术后并发症发生率等方面比较差异均无统计学意义(P＞0.05).结论 天麻素注射液可促进体外循环瓣膜置换术患者术后早期认知功能恢复,但对远期POCD的发生率没有明显影响.
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