关于监测深低温停循环主动脉手术期间脊髓缺血性损伤的思考

Thinking about the Monitoring of the Spinal Cord Ischemic Reperfusion Injury during the Aortic Surgery with Deep Hypothermic Circulatory Arrest

脊髓缺血再灌注损伤(spinal cord ischemic reperfusion injury,SCIRI)是深低温停循环(deep hypothermic circulatoryarrest,DHCA)主动脉手术期间一种致命性的并发症,它对患者和其家属及医务人员带来严重的身心危害。在DHCA主动脉手术期间早期监测和发现SCIRI实属必要,同时论证了其可行性。针对DHCA主动脉手术期间如何有效监测SCI-RI,作者深入思考以下问题:监测手段的可行性和实用性、监测指标的敏感性和特异性、监测费用的经济性。

Spinal cord ischemic reperfusion injury（SCIRI）is a fatal complication during the aortic surgery with deep hypothermic circulatory arrest（DHCA）, which can induce seriously physical and psychological harm to the patients themselves , their families and the related medical staffs. In the article, the necessity of the early monitoring and detection of the SCIRI during the aortic surgery with DHCA was pointed out by the authors, and the feasibility for doing this was demonstrated. For the effective monitoring of the SCIRI, the following issues were pondered by the authors, the feasibility and the practicality of the used monitoring instruments, the sensitivity and the specificity of the selected monitoring indicators, and the optimization of monitoring costs.