Yamashita C, Ataka K, Yoshida M, Sugimoto T, Wakiyama H, Okada M
Department of Surgery, Kobe University School of Medicine.
Kobe J Med Sci. 1998 Dec;44(5-6):191-7.
From 1994 to 1997, 11 consecutive patients with thoracoabdominal aneurysms underwent surgery using cardiopulmonary bypass under moderate hypothermia (33 degrees C) and selective visceralartery perfusion for spinal cord and visceral organ protection. Distal perfusion pressure was maintained above 60 mmHg (mean) during cardiopulmonary bypass. In the four patients, one or two pairs of large intercostal arteries between Th10 and L2 were reimplanted. In the four patients, visceral and renal arteries were reconstructed. Surgical mortality rate within 1 month was 18.2% (2/11). One patient died of bleeding from old empyema and another of multiple organ failure. No patients had paraplegia. In conclusion, cardiopulmonary bypass with selective visceral artery perfusion under moderate hypothermia may contribute to the prevention of the occurrence of paraplegia and acute renal failure.
1994年至1997年，连续11例胸腹主动脉瘤患者在中度低温（33摄氏度）下使用体外循环进行手术，并采用选择性内脏动脉灌注以保护脊髓和内脏器官。体外循环期间，远端灌注压力维持在60 mmHg（平均）以上。4例患者中，在胸10和腰2之间重新植入了一对或两对大的肋间动脉。4例患者中，对内脏动脉和肾动脉进行了重建。1个月内的手术死亡率为18.2%（2/11）。1例患者死于陈旧性脓胸出血，另1例死于多器官功能衰竭。无患者发生截瘫。总之，中度低温下选择性内脏动脉灌注的体外循环可能有助于预防截瘫和急性肾衰竭的发生。
