脑脊液排水在下降和胸腔腹腔大动脉置换手术中的安全性
Afsheen Nasir1, Mohammad A Zafar1, Mohamed Abdelbaky1
1Aortic Institute at Yale-New Haven Hospital, Yale University School of Medicine, New Haven, CT, USA.
Annals of cardiothoracic surgery
|October 11, 2023
概括
大脑脊髓液排水 (CSFD) 是一种安全的策略,可以在大动脉动脉瘤修复过程中防止脊髓损伤 (SCI). 虽然出现轻微的并发症,但CSFD可能会减少那些接受下降胸腔和胸腔腹腔大动脉动脉瘤手术的患者的主要神经缺陷.
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:
- 脊髓损伤 (SCI) 是下降胸前动脉动脉瘤 (DTAA) 和胸腔腹腔动脉动脉瘤 (TAAA) 修复的重大并发症.
- 大脑脊髓液排水 (CSFD) 在这些大动脉疾病的开放性手术修复过程中被用作一种保护措施.
研究的目的:
- 评估在DTAA和TAAA的开放性手术修复期间与CSFD的17年经验.
- 评估CSFD在该患者群体中预防SCI的安全性和有效性.
主要方法:
- 对132名患者进行DTAA/TAAA的开放性修复,同时患有CSFD的患者进行了回顾性图表审查.
- 从电子健康记录中提取的生存,术后过程和CSFD相关并发症的分析.
主要成果:
- 平均年龄为65.4岁,62.1%是男性. 住院死亡率为7.6%.
- 在3.0%的患者中发生永久性. 与CSFD相关的并发症 (例如,CSF泄漏,腹腔内血瘤) 在19%的患者报告.
- 在15年后,长期生存率为50.9%.
结论:
- CSFD是一种安全的做法,与轻微的并发症和没有重大后果有关.
- 在接受DTAA和TAAA开放修复的患者中,CSFD可能会导致SCI减少.
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