目前在开放胸腔腹腔大动脉动脉瘤修复过程中保护脊髓的方法
Joseph S Coselli1,2,3, Scott A LeMaire1,2,3, Vicente Orozco-Sevilla1,2,3
1Division of Cardiothoracic Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX, USA.
Annals of cardiothoracic surgery
|October 11, 2023
概括
在胸腔腹腔大动脉动脉瘤修复后预防脊髓缺陷 (SCD) 需要仔细的外科手术管理. 术内策略和避免低血压是最大限度地降低SCD风险和减轻损伤的关键.
科学领域:
- 心血管外科心血管外科
- 神经外科 神经外科
- 血管外科 血管外科
背景情况:
- 脊髓缺陷 (SCD) 是胸腔腹腔大动脉瘤 (TAAA) 修复后的一个重大并发症.
- 尽量减少SCD风险需要全面的外科手术期间管理策略.
研究的目的:
- 审查在TAAA修复期间预防SCD的外科外科和外科外科考虑.
- 突出SCD早期识别和干预的重要性.
主要方法:
- 讨论手术前风险分层的讨论.
- 对手术内技术的审查,包括脑脊液排水,左心绕道,低温和选择性动脉再植入.
- 在整个外科手术期间强调血液动力学和血液学监测.
主要成果:
- 积极主动管理可以显著降低SCD的发病率.
- 特定的手术内措施可以保护脊髓输液和生命力.
- 避免低血压和贫血对于预防神经损伤至关重要.
结论:
- 警的术后护理,包括特定的术内策略,对于减少TAAA修复后的SCD至关重要.
- 早期检测和及时的治疗干预对于减轻脊髓损伤至关重要.
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