A PROSPECTIVE RANDOMIZED STUDY OF CEREBROSPINAL-FLUID DRAINAGE TO PREVENT PARAPLEGIA AFTER HIGH-RISK SURGERY ON THE THORACOABDOMINAL AORTA
A PROSPECTIVE RANDOMIZED STUDY OF CEREBROSPINAL-FLUID DRAINAGE TO PREVENT PARAPLEGIA AFTER HIGH-RISK SURGERY ON THE THORACOABDOMINAL AORTA
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DOI：
10.1016/0741-5214(91)90010-r
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发表时间：
1991-01-01
影响因子：
4.3
通讯作者：
RIVERA, V
中科院分区：
文献类型：
--
作者：
CRAWFORD, ES;SVENSSON, LG;RIVERA, V
本文研究了几个变量的影响，主要是脑脊液引流，在一个前瞻性随机系列的广泛动脉瘤患者的神经功能缺损的发生率下降的胸和腹主动脉（胸腹I型和II型）。46例患者进行了脑脊液引流，52例为对照组，共有98例可用于研究。主动脉阻断组持续监测脑脊液压力，20例患者主动脉阻断期间脑脊液压力维持在≤ 10mmHg，20例患者脑脊液压力维持在≤ 15mmHg，6例患者脑脊液压力> 15mmHg。治疗方法包括肋间和腰动脉再附着（p = 0.2）、主动脉闭塞期间临时性房股分流术（p = 0.3）和脊髓液引流（p = 0.8），在降低神经功能缺损发生率方面无统计学显著性。因此，我们使用的脑脊液引流对预防截瘫没有好处。在适当的统计分析中，我们发现迟发性功能障碍的唯一重要预测因素是术后低血压（p = 0.006）。
This article is concerned with the study of the effect of several variables, principally that of cerebrospinal fluid drainage, on the incidence of neurologic deficit in a prospective randomized series of patients with extensive aneurysms of the descending thoracic and abdominal aorta (thoracoabdominal type I and II). Forty-six patients had cerebrospinal fluid drainage, and 52 were controls, with a total of 98 available for study. Cerebrospinal fluid pressure was continuously monitored in the former group and pressure maintained less-than-or-equal-to 10 mm Hg in 20, less-than-or-equal-to 15 mm Hg in 20, and > 15 mm Hg in 6 patients during period of aortic clamping. The method of treatment including reattachment of intercostal and lumbar arteries (p = 0.2), temporary atriofemoral bypass during aortic occlusion (p = 0.3), and spinal fluid drainage (p = 0.8) were not statistically significant in reducing the incidence of neurologic deficits. Thus cerebrospinal fluid drainage as we used it, was not beneficial in preventing paraplegia. On appropriate statistical analysis we found that the only significant predictor of delayed deficits was postoperative hypotension (p = 0.006).