Diagnosis and Prevention for Spinal Cord Injury using Spinal Cord Plegia and Spinal Cord Cooling Pad during Thoracic Aortic Aneurysm Surgery

胸主动脉瘤手术中脊髓麻痹和脊髓冷却垫对脊髓损伤的诊断和预防

• 批准号: 15390417
• 负责人: SUEDA Taijiro
• 金额: $ 9.66万
• 依托单位: HIROSHIMA UNIVERSITY
• 依托单位国家: 日本
• 项目类别: Grant-in-Aid for Scientific Research (B)
• 财政年份: 2003
• 资助国家: 日本
• 起止时间: 2003 至 2004
• 项目状态: 已结题
• 来源: https://kaken.nii.ac.jp/en/grant/KAKENHI-PROJECT-15390417/
• 关键词: thoracic aortic aneurysm; spinal cord ischemic; motor evoked potentials; spinal cord plegia; spinal cord cooling pad; paraplegia; 脊髄誘発電位

This study was scheduled to clarify the critical ischemic time to occur paraplegia during thoracic aortic aneurysm and how to diagnose the site of critical intercostals arteries and protect spinal cord from ischemic spinal cord injury.In animal experiements, efficacy of cold saline (spinal cord plegia) injection into the clamped aortia was investgated using evoked-spinal cord potentials during simple aortic cross clamping in canine model. Cold saline injection revealed prompt decrease of spinal cord potentials and minimized spinal cord injury, comparing with simple aortic cross clamping. Propofol (neuron protective agent) was added to the spinal cord plegia and examined how to decrease spinal cord injury after simple aortic cross clamping. Propofol was effective to decrease spinal cord injury during aortic cross clamping. Spinal cord cooling pad was also devised and used as a cooling instrument outside from the spine. Spinal cord cooling pad decreased spinal cord temperature quickly and protected spinal cord from ischemic injury.In clinical study, cold blood spinal cord plegia was infused into the clamped aorta during thoracoabdominal aortic aneurysm surgeries. Cold blood infusion decreased spinal cord evoked potentials quickly and effective to determine the location of the critical intercostal arteries in the clamped segment.

本研究旨在明确胸主动脉瘤发生截瘫的关键缺血时间，以及如何诊断关键肋间动脉部位并保护脊髓免受缺血性脊髓损伤。在动物实验中，使用简单主动脉交叉夹紧期间的诱发脊髓电位来研究向夹紧的主动脉注射冷盐水（脊髓麻痹）的效果。 犬模型。与简单的主动脉阻断相比，冷盐水注射显示脊髓电位迅速降低并最大限度地减少脊髓损伤。将异丙酚（神经元保护剂）添加到脊髓麻痹液中，并研究如何在简单的主动脉阻断后减少脊髓损伤。异丙酚可有效减少主动脉阻断期间的脊髓损伤。还设计了脊髓冷却垫并将其用作脊柱外部的冷却工具。脊髓冷却垫能快速降低脊髓温度，保护脊髓免受缺血性损伤。临床研究中，在胸腹主动脉瘤手术中将冷血脊髓麻痹液注入夹紧的主动脉中。冷血输注可快速有效地降低脊髓诱发电位，从而确定夹紧节段中关键肋间动脉的位置。

项目成果

Near-infrared spectroscopy for monitoring cerebral ischemia during selective cerebral perfusion

• DOI: 10.1016/j.ejcts.2004.06.014
• 发表时间: 2004-11-01
• 期刊: EUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY
• 影响因子: 3.4
• 作者: Orihashi, K;Sueda, T;Imai, K
• 通讯作者: Imai, K

Yuji Sugawara: "Surgical treatment of aortic coarctation associated with multi-vessel Brachiocephalic involvemant in Takayasu's arteritis"Ann Thorac Cardiovasc Surg. 9. 202-205 (2003)

Yuji Sukawara：“高安动脉炎中与多血管头臂受累相关的主动脉缩窄的手术治疗”Ann Thorac Cardiovasc Surg。

Echo-guided identification of key lumber arteries for the spinal cord : Preliminary study in the canine model

回波引导下识别脊髓关键腰动脉：犬模型的初步研究

• 发表时间: 2004
• 期刊: Hiroshima J Med Sci 54
• 作者: 大須賀慶悟;永野浩昭;他;Aleshin A.;Orihashi Kazumasa
• 通讯作者: Orihashi Kazumasa

Taijiro Sueda: "Fate of aneurysms of the distal arch and proximal descending thoracic aorta after transaortic endovascular stent-grafting"Ann Thorac Surg. 76. 84-89 (2003)

Taijiro Sueda：“经主动脉血管内支架移植术后远端弓形和近端降胸主动脉瘤的命运”Ann Thorac Surg。

Successful shrinkage of distal arch and proximal descending aortic aneurysm after transaortic endovascular stent-grafting

经主动脉血管内覆膜支架成功缩小远端弓和近端降主动脉瘤

• 发表时间: 2004
• 期刊: Eur J Cardio-thoracic Surg 26
• 作者: Tanaka;F. et al.;Sueda Taijiro
• 通讯作者: Sueda Taijiro