脑脊液引流治疗主动脉夹层术后脊髓损伤8例

Cerebrospinal fluid drainage in treating 8 cases of spinal cord injury after aortic dissection operation

目的探讨主动脉夹层(AD)术后脊髓损伤(SCI)患者脑脊液(CSF)引流的作用。方法选取2011年1月至2021年4月该院收治的行AD手术患者631例,术后发生SCI 8例,其中接受开胸手术7例,血管内主动脉修复(TEVAR)手术1例。均于麻醉清醒后常规评估肢体功能,发现异常后立即行CSF引流术,在CSF引流术后7 d或患者肌力恢复后拔除引流管。术后随访6~24个月,根据临床资料分析CSF引流的临床特点和病程。结果AD术后SCI发生率为1.27%(8/631),开胸手术后SCI发生率为1.59%(7/440),TEVAR术后SCI发生率为0.52%(1/191)。随访期间6例患者基本康复,2例患者诊断为截瘫。结论CSF引流是治疗AD术后SCI的有效方法。

Objective To investigate the effects of cerebrospinal fluid(CSF)drainage in spinal cord injury(SCI)after aortic dissection(AD)operation.Methods A total of 631 patients with AD operation in this hospital from January 2011 to April 2021 were selected.Among them,SCI occurred in 8 cases,in which 7 cases received the open chest surgery,and 1 case underwent thoracic endovascular aortic aneurysm repair(TEVAR).The limb function was routinely evaluated after awake,and the CSF drainage was performed immediately after abnormalities were found.The drainage tube was removed within postoperative 7 d or after muscle strength recovery.Six cases had Paeients were followed up from 6.The clinical characteristics and course of CSF drainage were analyzed according to clinical data.Results The occurrence rate of SCI after AD was 1.27%(8/631),which after open surgery was 1.59%(7/440)and which after TEVAR was 0.52%(1/191).During followed up period,6 cases were basically recovered and 2 cases were diagnosed as paraplegia.Conclusion The CSF drainage is an effective method for treating SCI after AD operation.