Mechanical circulatory support decreases neurologic complications in the treatment of traumatic injuries of the thoracic aorta.
Mechanical circulatory support decreases neurologic complications in the treatment of traumatic injuries of the thoracic aorta.
复制标题
机械循环支持可减少胸主动脉创伤性损伤治疗中的神经系统并发症。
DOI：
10.1001/archsurg.1992.01420050036003
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发表时间：
1992
影响因子：
--
通讯作者：
John C. Baldwin
中科院分区：
文献类型：
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作者：
Robert S.D. Higgins;Juan A. Sanchez;Linda DeGuidis;Michael L. Dewar;Kenneth L. Franco;Gary S. Kopf;J. Elefteriades;Graeme L. Hammond;John C. Baldwin
创伤性胸主动脉损伤的外科治疗是有争议的，因为一些技术方法已被推荐。尽管采用了这种技术，但脊髓缺血仍然是一个持续存在的问题。从1984年到1991年，在耶鲁-纽黑文（康涅狄格州）医学中心治疗了19例确诊为钝性创伤继发性主动脉损伤的患者。将患者分为两组进行分析：第1组（n = 10）采用机械循环支持进行修复，第2组（n = 9）在无机械循环支持的情况下进行修复。16名患者存活。3例患者死于多发伤并发症。两组在主动脉阻断时间、术前收缩压和损伤严重程度评分方面具有可比性。非机械支持组中有3名患者发生神经系统并发症（P <0.05）。机械支持组无患者发生神经系统并发症。我们相信机械循环支持可以降低胸主动脉创伤后神经系统并发症的发生率，临床上只要可行就应该使用。
The surgical treatment of traumatic injuries of the thoracic aorta is controversial because a number of technical approaches have been recommended. Despite the technique employed, spinal cord ischemia continues to be a persistent problem. Nineteen patients with confirmed aortic injuries secondary to blunt trauma were treated at the Yale-New Haven (Conn) Medical Center from 1984 to 1991. The patients were analyzed in two groups: group 1 (n = 10) underwent repair using mechanical circulatory support and group 2 (n = 9) underwent repair without mechanical circulatory support. Sixteen patients survived. Three patients died of complications of multiple trauma. The groups were comparable with respect to aortic cross-clamp time, preoperative systolic blood pressure, and Injury Severity Score. Three patients in the nonmechanical support group developed neurologic complications (P less than .05). No patient in the mechanical support group had a neurologic complication. We believe that mechanical circulatory support reduces the incidence of neurologic complications following traumatic injuries of the thoracic aorta and should be used whenever clinically feasible.