[Structure and dynamics of mental disorders in patients before heart surgery and in the early postoperative period.].
A total of 106 patients aged 60,2+/-8,7 years were entered in the study. They underwent surgery on the open heart (coronary artery bypass grafting) using cardiopulmonary bypass (78 patients) under normothermic (38 patients) or hyporthermic (36 patients) conditions. The control group consisted of patients who underwent surgery on the working heart without the use of cardiopulmonary bypass (32 patients). Patients were studied before the operation and on the 5th and 14th days after it. In the preoperative period, psychic pathology was detected in more than half of patients. Neurotic disorders prevailed and affective disorders and the psychoorganic syndrome were detected as well. In the early postoperative period, an increase of frequency of mental disorders was noted in all groups, the clinical picture being more complicated. Memory and intellectual insufficiency of transitory nature measured with the Mini Mental State Examination (MMSE) scale was revealed. Cases of postcardiotomic delirium were observed. Patients of the normothermic group demonstrated milder signs and faster reduction of part of mental disorders as compared to the hypothermic group. The results of the study suggest that the normothermic method versus hypothermia is more preferential for the postoperative psychic state of cardiac patients.
Krenkel'
G L
GL
Kafedra psikhiatrii i meditsinskoĭ psikhologii Moskovskoĭ meditsinskoĭ akademii im. I.M. Sechenova.
D002315:Cardiopulmonary Bypass; D001026:Coronary Artery Bypass; D003693:Delirium; D006801:Humans; D011184:Postoperative Period; D011446:Prospective Studies