Shinpo H, Kondo C, Shimono T, Tnanaka K, Yada I, Yuasa H, Kusagawa M
Department of Thoracic and Cardiovascular Surgery, Mie University School of Medicine, Japan.
ASAIO J. 1993 Jul-Sep;39(3):M202-3.
Patients with aortic arch aneurysms underwent surgery using a selective cerebral perfusion (SCP) method. For this purpose, a protocol for SCP was established on the basis of an animal experimental study. Our SCP procedure is performed at a perfusion rate of 6 ml/kg/min with the patient under deep hypothermia at 20 degrees C. The subject group in the current study included 36 patients, 28 men and eight women, ranging in age from 23 to 84 years (mean, 61). There were five operative deaths (13.9%). The mean cardiopulmonary bypass time was 288 minutes, and the mean aortic clamp time was 135 minutes. Mean SCP time was 89 minutes, exceeding 90 minutes in 17 cases. The mean blood pressure during SCP was 43 mmHg and oxygen saturation rate in the internal jugular vein was at least 90%. There was no definite production of lactate in the brain. Cerebral disorders considered to have been caused by SCP occurred in only two cases. It appears that cerebral metabolism can be maintained safely, and that our SCP method is useful during surgery for aortic arch aneurysms.
主动脉弓动脉瘤患者采用选择性脑灌注（SCP）方法进行手术。为此，在动物实验研究的基础上制定了SCP方案。我们的SCP程序是在患者处于20摄氏度的深度低温状态下，以6毫升/千克/分钟的灌注速率进行的。本研究的受试者组包括36例患者，其中28例男性和8例女性，年龄在23至84岁之间（平均61岁）。有5例手术死亡（13.9%）。平均体外循环时间为288分钟，平均主动脉阻断时间为135分钟。平均SCP时间为89分钟，17例超过90分钟。SCP期间的平均血压为43毫米汞柱，颈内静脉血氧饱和度至少为90%。脑内未明确产生乳酸。仅2例发生了被认为是由SCP引起的脑部疾病。似乎脑代谢可以安全维持，并且我们的SCP方法在主动脉弓动脉瘤手术中是有用的。
