冠状动脉旁路移植术围术期神经系统并发症评估与管理专家共识  

Expert Consensus on Evaluation and Management of Perioperative Neurological Complications of Coronary Artery Bypass Grafting

作　　者：北京神经科学学会脑心共患病专业委员会 李淑娟 凤玮 周瑛华 胡展 王玮婧 张贵涛 周琪琳 冯瑶 胡国良 Neuro-cardiological Disease Professional Committee,Beijing Society of Neuroscience;LI Shujuan;FENG Wei

机构地区：[1]不详 [2]中国医学科学院阜外医院

出　　处：《中国循环杂志》2025年第2期105-123,共19页Chinese Circulation Journal

基　　金：四大慢病重大专项(2023ZD0504703)。

摘　　要：冠状动脉旁路移植术(coronary artery bypass grafting,CABG)是冠心病的有效治疗措施之一,但围术期神经系统并发症严重影响患者的预后,并增加家庭及医疗负担。CABG围术期神经系统并发症主要包括脑卒中、癫痫、神经认知障碍以及周围神经损伤,主要与手术术式、手术时间以及术中所用药物有关。既往研究发现,规范术前和术中评估、加强术中监测和术后干预有利于早期发现神经功能障碍并及时给予治疗,减少神经系统并发症,从而改善CABG患者预后。本专家共识总结了CABG围术期神经系统并发症的早期识别及诊疗规范,以指导CABG围术期并发症的规范化管理,降低术后早期死亡率及并发症发生率,改善患者的长期预后。Coronary artery bypass grafting(CABG)is one of the effective treatment methods for coronary heart disease.However,perioperative neurological complications related to CABG seriously affect the outcomes of patients,and increase the burden on families and medical care.Perioperative neurological complications of CABG mainly include stroke,epilepsy,neurocognitive impairment and peripheral nerve injury.Most of the risk factors are related to the surgical type,operation time and intraoperative drugs used.Most studies reported that standardized preoperative and intraoperative assessment,intraoperative monitoring,and postoperative management are meaningful to early detection of neurological dysfunction,timely intervention,and reduction of neurological complications,thus improving the prognosis of patients undergoing CABG.This expert consensus summarizes the early identification and treatment norms of perioperative neurological complications of CABG,aiming to guide the standardized management of perioperative complications of CABG,reduce the early postoperative mortality and complication rate,and improve the long-term prognosis.

关 键 词：冠状动脉旁路移植术 脑卒中 癫痫 认知障碍 周围神经损伤 

分 类 号：R54[医药卫生—心血管疾病]