The Effect Of Beating Heart Surgery On S100_β,NSE

Objective:by measuring the change of plasma S100β, NSE in the arrested heart surgery and beating heart surgery of Rheumatic heart disease at different time points, we understand the trends of S100β, NSE plasma concentration, MMSE was recorded one day preoperative and one week postoperative. make a comparison between beating heart surgery and arrested heart surgery on S100β,NSE,MMSE.Methods:patients Selection criteria:adult patients with rheumatic heart disease 32 cases between March 2009 to June 2009 period of admission, cardiac functionⅡ-Ⅲgrade, using computer random generated way to allocate arrested heart surgery group of 16 patients and beating heart surgery group of 16 patients, There was no significant difference in statistically between two groups of patients, no hypertension, diabetes, cerebralvascular diseases, psychological disorders, heart surgery history, left atrial thrombus and other relevant medical history. Anesthesia induction with midazolam, vecuronium, fentanyl and etomidate, and than endotracheal intubation, mechanical control of ventilation, maintenance of anesthesia using midazolam, vecurinium, fentanyl. Conventional median thoracotomy, heparin dosage 4mg/kg, ACT>480S before cardiopulmonary bypass start and maintain MAP:70±10mmHg during cardiopulmonary bypass, the blood oxygen partial pressure>150 mmHg, cardioplegia group of temperature control in the 28±1℃, perfusion index:2.6-3.0 1/m2.min, beating heart surgery group control 33±1℃, perfusion index:2.8-3.2 1/m2.min, after the end of heart surgery 1.0-1.5:1 of protamine Neutralize heparin. Observation time TO:after the anesthesia induction; T1:30 minutes after CPB begin, T2:10 minutes after the end of CPB; T3:4 hours after CPB; T4:24h after CPB; T5:72h after CPB. Record indicators:plasma S100β, NSE contents. All data are corrected with preoperative Hct. MMSE evaluation processed 24 hours preoperative and a week postoperative. Using statistical SPSS13.0 for statistical analysis, comparisons between different time points in group using repeated measures analysis of variance.Results:1 plasma of S100β,NSE are rising after the start of operation, reach the peak 4 hours after CPB and back to normal 72 hours after CPB, The difference was statistically significant.2 The changes of plasma S100β, NSE in beating heart surgery group is less than arrested heart surgery group, The difference was statistically significant.3 The MMSE reduction in beating heart surgery is low than in arrested group.Conclusion:Beating heart surgery cause less effect of S100β,NSE,MMSE compared to arrested heart surgery.