Berendes J N, Bredée J J, Schipperheyn J J, Mashhour Y A
Circulation. 1982 Aug;66(2 Pt 2):I112-6.
Cross-clamping of the descending thoracic aorta for surgical correction of coarctation carries a risk of injury to the spinal cord, which is usually attributed to insufficient blood supply along the spinal arteries. To detect inadvertent interruption of spinal cord perfusion, lumbar pressure was monitored during operation on the aorta in eight patients. One patient incurred ischemic damage of the spinal cord, resulting in paraparesis. In this patient, spinal fluid pressure increased to such high levels that it may have caused tamponade of the cord. The pressure increase resulted from expansion of cerebral vessels caused by an acute rise of arterial pressure after clamping, probably aggravated by the administration of a vasodilating drug. During operations in which the circulation of the spinal cord is compromised long enough to cause ischemic damage, the femoral artery and spinal fluid pressures should be monitored. If the pressure difference between femoral artery and lumbar cavity drops to a dangerously low level, a shunting procedure should be performed.
为手术矫正主动脉缩窄而对胸降主动脉进行交叉钳夹会有脊髓损伤的风险，这通常归因于沿脊髓动脉的血液供应不足。为检测脊髓灌注的意外中断，在8例患者的主动脉手术过程中监测了腰段压力。1例患者发生脊髓缺血性损伤，导致双下肢轻瘫。在该患者中，脊髓液压力升高到很高水平，可能导致了脊髓受压。压力升高是由于钳夹后动脉压急性升高引起脑血管扩张所致，使用血管扩张药物可能使其加重。在脊髓循环受损时间足够长以致引起缺血性损伤的手术过程中，应监测股动脉和脊髓液压力。如果股动脉与腰段腔之间的压力差降至危险的低水平，应进行分流手术。
