Experimental studies for safety on the operation of transverse aortic arch aneurysm. -A Study of Corticospinal Direct Response-

主动脉弓横动脉瘤手术安全性的实验研究。

• 批准号: 02670610
• 负责人: KAZUI Teruhisa
• 金额: $ 1.22万
• 依托单位: Sapporo Medical College
• 依托单位国家: 日本
• 项目类别: Grant-in-Aid for General Scientific Research (C)
• 财政年份: 1990
• 资助国家: 日本
• 起止时间: 1990 至 1991
• 项目状态: 已结题
• 来源: https://kaken.nii.ac.jp/grant/KAKENHI-PROJECT-02670610/
• 关键词: Tranverse aortic arch aneurysm; Profound hypothermic circulatory arrest; Selective cerebral perfusion; Corticospinal direct response; Evoked Spinal Cord Potential; Brain function; 伝導性脊髄誘発電位(ESCP); 脳循環停止許容時間

The reconstruction of the transverse aortic arch is very complicated and spends a long time period, so it is essential to select the appropriate support technique to prevent cerebral ischemia. Recently it has been reported that profound hypothermic circulatory arrest(PHCA)or selective cerebral perfusion(SCP)are very useful as support procedure for preventing cerebral ischemia. However, PHCA is subject to limitations on the duration of cerebral circulatory arrest and a safe interval of circulatory arrest time has not been determined yet, and optimal selective cerebral perfusion flow and pressure in SCP is now discussing.And as for brain protection, it is also important to evaluate brain function during operation for preventing brain complication. The methods of the evaluation of brain function include the electrophysiological examinations such as corticospinal direct response(CDR), evoked spinal cord potential(ESCP)and somatosensory evoked potential(SEP).An experimental study was design … More ed to clarify the safety margins for cerebral circulatory arrest(CCA)under profound hypothermia by means of continuous measurement of evoked potential and histopathological studies of the brain and spinal cord tissues. Adult mongrel dogs were anesthetized with thlopental sodium and cooled to rectal temperature(RT)15 ﾟC with cardiopulmonary bypass and divided into 3 groups ; PHCA was performed for 30 minutes in Group I, 60 minutes in Group II, 90 minutes in Group III, and the next conclusion was gotten by CDR, ESCP and histopathological studies.1. PHCA at RT 15 ﾟC for at most 60 minutes would be safe for the preservation of brain function in view of CDR and a hypothermic preventive effect at the spinal cord could be maintained for 90 minutes or possibly longer at RT 15 ﾟC.2. CDR is a valid parameter for monitoring brain function in CPB.And in addition to this experiment we have been doing the experiment to decide optimal cerebral perfusion flow and pressure in SCP with monitoring brain function by CDR and SEP. Less

腹主动脉横弓重建过程复杂、耗时长，选择合适的支撑技术对预防脑缺血至关重要。近年来，有报道称深低温停循环(PHCA)或选择性脑灌注(SCP)是预防脑缺血的有效支持手段。然而，PHCA对脑循环停搏时间有一定的限制，安全的停循环时间间隔尚未确定，SCP中最佳的选择性脑灌注流量和压力正在讨论中。至于脑保护，术中评估脑功能对于预防脑并发症也很重要。脑功能的评价方法包括皮质脊髓直接反应、诱发脊髓电位和体感诱发电位等电生理检查。实验研究采用…通过脑组织和脊髓组织的诱发电位连续测定和组织病理学研究，进一步明确深低温下脑循环骤停(CCA)的安全范围。成年杂种犬麻醉后在体外循环下降温至直肠温度(RT)15ﾟC，随机分为3组，分别于术后30min、60min、90min进行体外循环，并通过彩色多普勒血流动力学、食道造影及组织病理学检查得出结论。考虑到CDR，在RT 15ﾟC下进行最多60分钟的PHCA对保存脑功能是安全的，而在RT 15ﾟC.2下，脊髓的低温预防效果可以维持90分钟或更长时间。CDR是监测CPB脑功能的有效参数。此外，我们还利用CDR和SEP对脑功能进行监测，以确定SCP的最佳脑灌注流量和压力。较少

项目成果

佐藤 浩樹: "超低体温下循環停止法における脳循環停止許容時間に関する実験的研究ーCorticospinal Direct Responseよりの検討ー" 札幌医学雑誌. 60. 269-281 (1991)

Hiroki Sato：“亚低温停循环中大脑停循环允许时间的实验研究 - 来自皮质脊髓直接反应的检查”札幌医学杂志 60. 269-281 (1991)。

Hiroki Satou: "Experimental Studies for Safe Interval of Cerebral Circulatory Arrest. -A Study of Corticospinal Direct response-." Sapporo Medical Journal. 60. 269-281 (1991)

Hiroki Satou：“脑循环骤停安全间隔的实验研究。-皮质脊髓直接反应的研究-”。

佐藤 浩樹: "超低体温下循環停止法における脳循環停止許容時間に関する実験的研究 ーCorticospinal Direct Responseよりの検討ー" 札幌医学雑誌. 60(3). (1991)

Hiroki Sato：“亚低温停循环中大脑停循环允许时间的实验研究 - 来自皮质脊髓直接反应的研究 -”札幌医学杂志 60(3)。