在胸内血管大动脉修复期间保护脊髓 - - 谁应该放置脊髓排水管?
1Department of Anesthesiology and Perioperative Medicine, Medical College of Georgia/Augusta University, Augusta, GA, USA.
Journal of spine surgery (Hong Kong)
|July 12, 2023
概括
在胸内血管大动脉修复 (TEVAR) 期间,腰椎脊髓排水管的适当放置对于脊髓保护至关重要. 干预放射学的图像引导安置为盲目技术提供了替代方案,有可能改善结果并降低风险.
科学领域:
- 神经外科 神经外科
- 心血管外科心血管外科
- 麻醉学 麻醉学
背景情况:
- 脊髓损伤 (SCI) 是胸内血管大动脉修复 (TEVAR) 的重要风险,特别是在克劳福德2型修复中.
- 建议使用腰椎脊柱排水来预防SCI,通过排水脑脊液 (CSF),但放置可能具有挑战性.
- 目前的盲人放置技术具有不一致的成功率和潜在的并发症.
研究的目的:
- 为了强调腰椎脊柱排水在TEVAR外科手术期间护理中的重要性.
- 为了解决困难的腰部排水位的临床困境.
- 提出图像导向光学作为盲目插入的替代方案.
主要方法:
- 对TEVAR目前基于证据的指导方针的审查.
- 讨论用于腰椎脊柱排水位的标准盲目技术.
- 通过干预放射学引入图像导向光学作为替代方案.
主要成果:
- 腰椎脊柱排水对于在TEVAR期间预防SCI至关重要.
- 在具有具有挑战性解剖学或先前手术的患者中,盲目放置可能会失败.
- 图像引导的放置提供了一个潜在的更安全和更有效的替代方案.
结论:
- 在TEVAR中,优化腰椎脊髓排水位对于脊髓保护至关重要.
- 应考虑图像导向光镜用于术前规划和安置.
- 这种方法可以减轻与盲目插入相关的风险,并提高患者的安全.
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