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.

这项研究计划澄清胸部主动脉瘤期间发生瘫痪的关键缺血时间犬模型。冷盐水注射显示，与简单的主动脉交叉夹紧相比，脊髓电位迅速降低并最小化脊髓损伤。将丙泊酚（神经元保护剂）添加到脊髓质性血统中，并检查了如何减少简单主动脉交叉夹紧后脊髓损伤。丙泊酚可有效地减少主动脉交叉夹具期间的脊髓损伤。还设计了脊髓冷却垫，并用作脊柱外部的冷却仪器。脊髓冷却垫迅速降低了脊髓温度，并保护脊髓免受缺血性损伤。在临床研究中，在胸腔主动脉瘤性动脉瘤手术期间，冷血脊髓胸膜血痛注入夹紧主动脉。冷血输注降低了脊髓迅速有效地诱发电位，以确定夹具块片段中关键的肋间动脉的位置。

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。

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。

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

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