New and future approaches for spinal cord protection.
New and future approaches for spinal cord protection.
复制标题
脊髓保护的新的和未来的方法。
DOI：
10.1016/j.yjmcc.2004.09.006
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发表时间：
1997
影响因子：
2.5
通讯作者：
L. Svensson
中科院分区：
文献类型：
--
作者：
L. Svensson
在主动脉手术期间和之后，脊髓损伤的主要原因是基于以下三种事件中的一种或多种的发生：（1）缺血的持续时间和程度;（2）修复后无法重建流向脊髓的血流;和（3）生化介导的再灌注损伤。临床上，这表现为永久性或可逆性截瘫或轻瘫，或神经源性膀胱。40多年来，已经尝试了许多方法来预防瘫痪，并且一些更新的技术创新包括减少缺血的持续时间、使用更新的离心泵远端灌注技术、局部低温、鞘内操作、药物制剂、血管造影术、体感诱发电位监测、脊髓运动诱发电位监测、氢标测、不切除后主动脉壁、支架的使用和一系列防止脊髓再灌注损伤的各种药理学试剂。其中一些技术和药物似乎可以有效降低脊髓损伤的风险。
The major cause of spinal cord injury, during and after aortic surgery, is based on the occurrence of one or more of the three following events: (1) the duration and degree of ischemia;(2) failure to re-establish blood flow to the spinal cord after the repair; and (3) a biochemically mediated reperfusion injury. Clinically, this manifests either as permanent or reversible paraplegia or paraparesis, or a neurogenic bladder. For more than 40 years, numerous methods have been attempted to prevent paralysis, and some of the newer technical innovations include reducing the duration of ischemia, the use of newer centrifugal pump distal perfusion techniques, localized hypothermia, intrathecal maneuvers, pharmacological agents, angiography, somatosensory-evoked potential monitoring, spinal motor-evoked potential monitoring, hydrogen mapping, not resecting the posterior aortic wall, the use of stents, and a spectrum of various pharmacological agents to prevent reperfusion injury to the spinal cord. Some of these techniques and agent seem to be effective at reducing the risk of spinal cord injury.