标志导向与光学导向的大脑脊髓液排水相关并发症在大动脉修复后的比较
Alan M Smeltz1, Mark A Farber2, F Ezequiel Parodi2
1Department of Anesthesiology, University of North Carolina at Chapel Hill, Chapel Hill, NC.
Journal of cardiothoracic and vascular anesthesia
|June 16, 2023
概括
大脑脊髓液排水 (CSFDs) 放置用于大动脉修复在光镜和里程碑指南之间的并发症没有显著差异. 光学引导的CSFD插入需要更少的尝试,可能会提高患者的耐受性.
科学领域:
- 心血管外科心血管外科
- 神经外科 神经外科
- 麻醉学 麻醉学
背景情况:
- 大脑脊髓液排水 (CSFDs) 对于在胸腔或胸腔腹腔大动脉修复过程中预防脊髓损伤至关重要.
- 光学用于CSFD放置的使用正在增加,取代了传统的基于地标的方法.
- 这两种指导技术之间缺乏关于并发症率的比较数据.
研究的目的:
- 在接受胸腔或胸腔腹腔大动脉修复的患者中,比较光学引导与基准引导的CSFD安置相关的并发症率.
- 评估不同CSFD插入技术的安全性和有效性.
主要方法:
- 一个回顾性队列研究是在一个中心进行的,持续了7年.
- 分析了150个使用里程碑指南和95个使用光学指南的CSFD放置的数据.
- 在对潜在混因素进行调整后,与CSFD安置相关的并发症在两组之间进行了比较.
主要成果:
- 接受光学引导CSFD的患者年龄较大,ASA得分较低,但需要更少的安置尝试.
- 在光镜组中,CSFD保持时间更长.
- 与CSFD相关的重大和轻微并发症的发生率在光镜和里程碑指导组之间是相似的 (p > 0.999).
结论:
- 无论是光学指导还是CSFD放置的里程碑式方法都没有显示出重大或轻微并发症风险的显著差异.
- 光镜辅助插入CSFD需要更少的尝试,可能提供更好的患者耐受性.
- 该研究强调需要平衡CSFD安置的风险与预防脊髓损伤的好处,无论使用哪种技术.
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