应用Fluosol—DA防止胸主动脉瘤切除术后并发下肢瘫痪的初步研究

APPLICATION OF FLUOSOL-DA FOR PREVENTING PARAPLEGIA COMPLICATED BY THORACIC ANEURYSMECTOMY

本文应用氟乐舒(Fluosol-DA)在实验犬拟行胸主动脉瘤切除术中,对防止脊髓缺血性损伤并发后肢瘫痪的作用进行了观察。实验组术中预防性使用 Fluosol-DA,阻断主动脉后远端动脉平均压为7.8±2.1kPa,而列照组为4.0±1.5kPa。两组对比差异有显著性(P<0.05)。术后24小时观察实验组犬后肢肌张力指数为3.7±0.5,对照组为1.6±1.0(<0.05)。所有实验组犬除1例并发后肢部分瘫痪外,余肌力正常无瘫痪表现。对照组所有实验犬均并发瘫痪。本实验结果表明:在阻断主动脉时,术中预防性使用 Fluosol-DA 有助于防止实验犬脊髓缺血性损伤,改善脊髓血液动力学。其机理可能与 Fluosol-DA 有高携氧能力,从而改善脊髓微循环血供有关。

The effectiveness of Fluosol-DA on circulatory dynamics and neurologicoutcome in dogs with ichemic spinal cord injury produced by aortic crosscla-mping was tested.In the experimantal group,Fluosol-DA(20 ml/kg bodyweight)was administered prophylactically,the distal pressure of cross clampedaorta was 7.8±2.1 kPa while in the control group,4.0±1.5kPa(p<0.05).Postoperative 24 hours′ observation found that all the experimental groupanimals except one dog reached normal hind legs movement with neurologicscore of 3.7±0.5,but the dogs in the control group were paraplegic withneurologic score of 1.6±1.0.The difference between these two groups was ofhigh statistical significance(P<0.05).The experimental results showed thatprophylactic use of Fluosol-DA could improve the spinal cord local blood mic-rocireulation and prevent the ischemia produced by the aortic crossclamping.