左心转流预防脊髓缺血损伤的实验研究

目的通过建立阻断胸降主动脉所致的脊髓缺血损伤的慢性动物模型,应用诱发电位监测脊髓缺血,研究左心转流技术在胸降主动脉手术中对脊髓缺血损伤的影响。方法 12只小型猪随机分为单纯阻断和左心转流组。在左无名动脉以远阻断降主动脉。术中使用诱发电位监测仪连续监测皮质体感诱发电位(CSEP),监测脊髓功能变化。术后每日记录动物行为学评分。结果单纯阻断组中1只动物后肢轻瘫,其余后肢均截瘫。左心转流组动物恢复顺利,无截瘫发生。单纯阻断组CSEP波幅降低达50%以上,潜伏期延长10%以上,变化与行为学评分一致。结论左心转流较单纯阻断能提供更为良好的脊髓保护作用。

The study on preventing the spinal cord ischemic injury using left heart bypass

OBJECTIVE ITo compare the impact of single clamp（SC） versus left heart bypass（LHB） technique on spinal sord ischemia monitored by Cortical Somatosensory Evoked Potentials（CSEP）.METHODS 12 piglets were divided into SC group and LHB group randomly.The thoracic descending aorta was clamped at distal to left innominate artery.CSEP was recorded to monitor the function of spinal cord.The behavior scores were observed every day after operation.Piglets were sacrificed at 7th day postoperatively.RESULTS All of animal developed paraplegia except one with incomplete paralysis in SC group.The animals in LHB group recovered completely and there were no cases of paralysis/paraplegia.The record of CSEP showed that amplitude decreased to below 50% of baseline and prolong of latency was more than 10% of baseline in SC group but not in LHB group.The change of CSEP was parallel with change of behavior score.CONCLUSION Left heart bypass may provide better protection than single clamp technique in the function of spinal cord.