Development of subarahnoid perfusion method on thoracoabdominal aneurysm repair

脊髓缺血导致的截瘫是胸主动脉和胸腹主动脉修复术后的严重并发症，即使在今天。方法新西兰白色大白兔2.5-3.0 kg，氟烷麻醉，经面罩吸入，观察KW 3345和核苷酸转运抑制剂潘生丁对主动脉修复术中脊髓缺血模型神经功能恢复和脊髓诱发电位的影响。通过在干净的剖腹手术下用血管团闭塞肾下腹主动脉、髂分叉和尾肠系膜动脉（脊髓的有效侧支循环）30分钟来产生脊髓缺血。部分椎板切除术后，将电极置于C3和L3水平的硬膜后部，连续记录脊髓诱发电位。实验组如下：第1组：仅给予生理盐水。第2组：脊髓缺血时肾下主动脉段给予KW 3345。第三组：结果所有动物均表现出后肢完全瘫痪的症状。结论经肾下主动脉段给予核苷酸转运抑制剂不能作为脊髓缺血的保护剂。

Bacground Spinal cord ischemia with resultant paraplegia is a serious complication after thoracic and thoracoabdominal aortic repair, even nowadays. This study was designed to investigate the effects of KW3345 and dipyridamole, a nucleotide transport inhibitor, on neurological recovery and spinal evoked potentials in a well established rabbit model of spinal cord ischemia during aortic repair.Method New Zealand white rabbits weighting 2.5-3.0 kg were anesthetized with halothane by an inhalation mask. Spinal cord ischemia was produced by occluding the infra-renal abdominal aorta, iliac bifurcation and caudal-mesenteric artery, a potent collateral cerculation to spinal cord, with a vascular clump for a period of 30 minutes under clean laparotomy. Spinal evoked potentials were continuously recorded with an electrode placed on the posterior portion of the dura at C3 and L3 level after partial laminectomy. The experimental groups were as follows, group 1 : only normal saline was administered. Group2 : KW3345 was administered to infra renal aortic segment during spinal ischemia. Group3 : Dipyridamole was administered to infra-renal aortic segment during spinal ischemia.Result All animals showed complete paralysis of the hind limbs. Spinal evoked potentials were not monitoered during ischemia in all animals.Conclusion Administration of nucleotide transport inhibitor through infra-renal aortic segment cannt be used as protection of ischemia of the spinal cord.