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Halli Krzyzaniak¹, Martina Vergouwen², Darren Van Essen²

¹From the Cumming School of Medicine, University of Calgary, Calgary, Alta. (Krzyzaniak, Vergouwen, Van Essen, Nixon); the Department of Surgery, Section of Vascular Surgery, University of Calgary, Calgary, Alta. (Krzyzaniak, Moore, Rommens); the Department of Cardiac Sciences, Section of Cardiac Surgery, University of Calgary, Calgary, Alta. (McClure); the Calgary Aortic Program, Calgary, Alta. (McClure, Moore, Rommens); the Department of Anesthesiology, Perioperative and Pain Medicine, University of Calgary, Calgary, Alta. (Nixon, Jadavji) halli.krzyzaniak@ucalgary.ca.

Canadian journal of surgery. Journal canadien de chirurgie

|December 13, 2024

概括

脑脊液 (CSF) 排水以预防大动脉手术期间脊髓缺血 (SCI) 在这项研究中没有重大并发症. 轻微并发症发生在17.8%,支持其继续用于SCI预防.

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:

脑脊液 (CSF) 排水是一种在胸腔腹腔大动脉手术期间减轻脊髓缺血 (SCI) 的技术.
最近的研究表明,与CSF排水相关的并发症率很高,促使实践修改.
这项研究评估了在接受胸腔腹腔大动脉手术的患者中与CSF排水相关的并发症率,并进行了外科手术期间的CSF排水放置.

研究的目的:

在接受胸腔腹腔大动脉手术的患者中调查CSF排水相关并发症的发生率.
评估外科手术期间的脑脊髓液排水对于SCI预防在这个患者群体中的安全性和有效性.

主要方法:

进行了一项单中心回顾性队列研究.
主要并发症包括内出血,外周血瘤/,脑膜炎和需要重新手术的保留导管.
轻微的并发症包括排水诱导的神经缺陷,中枢神经液泄漏,腹腔穿刺后头痛,中枢神经液无症状血液,排水失败,并保留了不需要重新手术的导管.

主要成果:

这项研究包括129名患者.
总体而言,永久性的发生率为3.9% (5例),只有1.6% (2例) 的患者有预防性CSF排水.
没有观察到与CSF排水相关的重大并发症;轻微并发症率为17.8%.

结论:

由于没有重大并发症,支持继续使用CSF排水作为SCI预防的辅助.
这些发现有助于现有的文献关于CSF排水并发症率的变化.
需要进一步的研究,以了解不同中心并发症率的变化.

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