Study On Cognitive Function And Psychological State After Carotid Endarterectomy

ObjectiveThis study was to observe the impact of carotid artery on cognitive function andpsychological state of patients and to evaluate the changes of them after carotidendarterectomy.MethodsThis study can be devided into2parts.PartⅠ: We got34patients in the experiment group and40in the control group whichwas admitted from June2013to December2013. The experiment groups was evaluatedwith MoCA before CEA,6~7days after CEA and3months after CEA. The controlgroup members were evaluated once they were taken in.Part Ⅱ: We had the34patients evaluated with SCL-90before CEA,6~7days afterCEA and3months after CEA.ResultsPartⅠ: Before CEA, the total score, executive function, visuospatial ability, naming,delayed recall, language and abstraction of the experiment group were significantlylower than the control group. The scores of the patients with bilateral lesion are lowerand there are significant difference between the patents with carotid lesion in thedifferent side. The cognitive function was not significantly improved6to7days aftersurgery, while the sense of orientation was declined（P<0.05）. The MoCA scores wereimproved3months after CEA, especially in the subtest of naming, delayed recall andabstraction.Part Ⅱ: Compared with the norm of Chinese adult, the total average scores of SCL-90,somatization, depression, anxiety, terror and psyehoticism were higher. Female andpatients with longer time span before surgery tend to have higher scores. No factors got better except depression6to7days after CEA. Terror and the additional factor gotworse meanwhile. The total average scores did not differ statistically between thepatient after CEA and the norm of Chinese. The scores of somatization,Obsessive-compulsive behavior, depression, psyehoticism and the additional factordeclined significantly compared with that before surgery, while the total average scoresand the factors of somatization, anxiety and terror are still higher than the norm.ConclusionCarotid stenosis have negative impact on the cognitive function and psychologicalhealth of patients. And CEA can help recover both of them in the long run. By usingMoCA, we can evaluate the cognitive function of the patients effectively and have aclearer prognosis. The doctors can distinguish the patient with poor psychological stateby knowing the characteristic of them and take care of them.