Raskin S A, Fuselier V W, Reeves-Viets J L, Coselli J S
Department of Surgery, Baylor College of Medicine, Houston, Texas, USA.
Int Anesthesiol Clin. 1996 Spring;34(2):177-93. doi: 10.1097/00004311-199603420-00014.
Our study indicated that RCP provided significant protection against both postoperative strokes and early death. However, in the subjects studied, the combined detrimental effects of postoperative stroke, COPD, cardiac complications, and procedures requiring composite valve replacement outweighed the protective benefit afforded by RCP in the prevention of early death. RCP's protective benefit was also diminished in the presence of pre-existing cerebrovascular disease. Although the major factors leading to the incidence of postoperative stroke and early mortality were the etiologies and pathologies brought to the operating theater by the patient, RCP when used in conjunction with DHCA significantly diminished the likelihood of either outcome. Therefore, given its simplicity of application in the surgical repair of aortic arch abnormalities, its indication seems warranted.
我们的研究表明，逆行脑灌注（RCP）对术后中风和早期死亡均提供了显著保护。然而，在所研究的受试者中，术后中风、慢性阻塞性肺疾病（COPD）、心脏并发症以及需要进行复合瓣膜置换的手术等综合不利影响超过了RCP在预防早期死亡方面所提供的保护益处。在存在既往脑血管疾病的情况下，RCP的保护益处也会减弱。尽管导致术后中风发生率和早期死亡率的主要因素是患者带入手术室的病因和病理情况，但RCP与深低温停循环（DHCA）联合使用时可显著降低这两种结果的发生可能性。因此，鉴于其在主动脉弓畸形手术修复中的应用简便性，其适应证似乎是合理的。
