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[硬膜外区域低温预防实验性主动脉钳夹所致截瘫]

[Epidural regional hypothermia for prevention of paraplegia in experimental aortic clamping].

作者信息

Radonak J, Marsala M, Marsala J

机构信息

II. chirurgická klinika LF UPJS, FN L. Pasteura Kosice.

出版信息

Rozhl Chir. 1999 Mar;78(3):109-13.

Abstract

In experiments on dogs the authors tried to elaborate methods of protection of the spinal cord from ischaemia during surgery of an aneurysm in the thoracolumbal portion of the aorta. They used the model described in the literature with double ligature of the aorta closely below the insertion of the left-sided subclavian artery and closely above the diaphragm for a period fo 40 minutes. In the control group of 8 dogs they observed severe neurological deficiency manifested by paraplegia in 7 animals. In the second group of 8 dogs the authors used local hypothermia of the spinal cord. Hypothermia was produced by epidural administration of 5 degrees C saline which they started to administer five minutes before clamping and continued throughout the period of ischaemia. The temperature of the spinal cord dropped to 26.8 degrees C. In this group none of the dogs developed neurological damage. The results were evaluated by recording spinal somatosensory potentials, by monitoring the neurological condition according to Tarlov and by histological examination of the spinal cord. In the conclusion they emphasize that this method can protect the spinal cord from 40-minute ischaemia.

摘要

在对狗的实验中,作者试图精心设计在胸腰段主动脉瘤手术期间保护脊髓免受缺血影响的方法。他们采用了文献中描述的模型,在左侧锁骨下动脉起始处下方紧邻处和膈肌上方紧邻处对主动脉进行双重结扎,持续40分钟。在8只狗的对照组中,他们观察到严重的神经功能缺损,7只动物出现截瘫。在第二组8只狗中,作者采用了脊髓局部低温。低温是通过硬膜外注入5摄氏度的生理盐水产生的,在夹闭前5分钟开始注入,并在整个缺血期间持续。脊髓温度降至26.8摄氏度。在该组中,没有一只狗出现神经损伤。通过记录脊髓体感诱发电位、根据塔尔洛夫法监测神经状况以及对脊髓进行组织学检查来评估结果。在结论中,他们强调该方法可保护脊髓免受40分钟的缺血影响。

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