Guérit J M
Service de Chirurgie vasculaire, Cliniques universitaires St Luc, U.C.L., Bruxelles.
Bull Mem Acad R Med Belg. 1998;153(7-9):325-31; discussion 332-3.
The neurological and neuropsychological complications of vascular and orthopedic surgery can be prevented by the early detection of the ischemic penumbra, that is, the stage at which the ischemic nervous structures are no more functional, but still alive and salvageable by reperfusion. This can be achieved by intraoperative neuromonitoring of the electroencephalogram and evoked potentials. We illustrate how these techniques led to improvement of the surgical strategy and patient outcome in carotid endarterectomies, descending aorta surgery and surgery performed under deep hypothermic circulatory arrest.
血管外科手术和矫形外科手术的神经学和神经心理学并发症可通过早期检测缺血半暗带加以预防,缺血半暗带即缺血性神经结构不再具备功能,但仍然存活且可通过再灌注挽救的阶段。这可通过术中对脑电图和诱发电位进行神经监测来实现。我们举例说明这些技术如何在颈动脉内膜切除术、降主动脉手术以及在深度低温循环停搏下进行的手术中改善了手术策略并提高了患者预后。