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アイテム
運動誘発電位監視下での胸部大動脈手術における冷却血液による脊髄保護
https://hiroshima.repo.nii.ac.jp/records/2005622
https://hiroshima.repo.nii.ac.jp/records/2005622160e5a45-c685-492a-9a6d-f0b1ec5f8954
| 名前 / ファイル | ライセンス | アクション |
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diss_ko5375.pdf (300.0 KB)
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審査の要旨 (187.0 KB)
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| Item type | デフォルトアイテムタイプ_（フル）(1) | |||||||||
|---|---|---|---|---|---|---|---|---|---|---|
| 公開日 | 2023-03-18 | |||||||||
| タイトル | ||||||||||
| タイトル | Cold blood spinoplegia under motor-evoked potential monitoring during thoracic aortic surgery | |||||||||
| 言語 | en | |||||||||
| タイトル | ||||||||||
| タイトル | 運動誘発電位監視下での胸部大動脈手術における冷却血液による脊髄保護 | |||||||||
| 言語 | ja | |||||||||
| 作成者 |
高橋, 信也
× 高橋, 信也
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| アクセス権 | ||||||||||
| アクセス権 | open access | |||||||||
| アクセス権URI | http://purl.org/coar/access_right/c_abf2 | |||||||||
| 主題 | ||||||||||
| 主題Scheme | NDC | |||||||||
| 主題 | 490 | |||||||||
| 内容記述 | ||||||||||
| 内容記述 | Objective: Motor-evoked potential monitoring is used to prevent paraplegia during thoracic aortic surgery. Multidetector computed tomography has been used preoperatively to detect the Adamkiewicz artery, but the hemodynamic significance of the Adamkiewicz artery is controversial. This study aims to evaluate whether the multidetector computed tomography–defined Adamkiewicz artery is hemodynamically essential and needs to be reconstructed with cold blood spinoplegia under motor-evoked potential monitoring. Methods: From 2005 to 2008, both preoperative multidetector computed tomographic analysis and intraoperative neurogenic motor-evoked potential monitoring with cold blood infusion into the clamped segment of the aorta were done in 15 patients. A motor-evoked potential decrease to less than 50% of the initial value at 3 minutes after cold blood infusion determined the hemodynamic significance of the multidetector computed tomography–defined Adamkiewicz artery. Adamkiewicz arteries determined to be essential were reconstructed, and those determined to be nonessential were sacrificed. Results: The Adamkiewicz artery was involved in the clamped segment of the aorta in 11 cases. After cold blood infusion, 8 patients experienced no significant motor-evoked potential decrease, and Adamkiewicz artery ligation was undertaken, whereas a moderate motor-evoked potential decrease was noted in 1 patient, prompting reconstruction. None of these 9 patients had permanent neurologic deficits. In 2 patients, the Adamkiewicz artery was reconstructed based on motor-evoked potential findings, with paraparesis occurring in 1 patient. In 4 patients without Adamkiewicz artery involvement in the clamped segment, there was no neurologic deficit. Conclusions: Cold blood infusion accelerates motor-evoked potential changes and might enable decision making regarding the need for reconstruction of multidetector computed tomography–defined Adamkiewicz arteries. Cold blood–loaded motor-evoked potential is beneficial to minimize Adamkiewicz artery reconstruction time and limit spinal cord ischemia. | |||||||||
| 言語 | en | |||||||||
| 言語 | ||||||||||
| 言語 | eng | |||||||||
| 資源タイプ | ||||||||||
| 資源タイプ識別子 | http://purl.org/coar/resource_type/c_db06 | |||||||||
| 資源タイプ | doctoral thesis | |||||||||
| 関連情報 | ||||||||||
| 関連タイプ | references | |||||||||
| 関連名称 | Shinya Takahashi, Kazumasa Orihashi, Katsuhiko Imai, Taketomo Mizukami, Taiichi Takasaki, and Taijiro Sueda; Cold blood spinoplegia under motor-evoked potential monitoring during thoracic aortic surgery; Journal of Thoracic and Cardiovascular Surgery, Volume 141, Issue 3, March 2011, Pages 755-761 (doi: 10.1016/j.jtcvs.2010.09.056) | |||||||||
| 関連情報 | ||||||||||
| 関連タイプ | references | |||||||||
| 識別子タイプ | DOI | |||||||||
| 関連識別子 | http://doi.org/10.1016/j.jtcvs.2010.09.056 | |||||||||
| 学位授与番号 | ||||||||||
| 学位授与番号 | 甲第5375号 | |||||||||
| 学位名 | ||||||||||
| 言語 | ja | |||||||||
| 学位名 | 博士(医学) | |||||||||
| 学位名 | ||||||||||
| 言語 | en | |||||||||
| 学位名 | 博士(医学) | |||||||||
| 学位授与年月日 | ||||||||||
| 学位授与年月日 | 2011-01-27 | |||||||||
| 学位授与機関 | ||||||||||
| 学位授与機関識別子Scheme | kakenhi | |||||||||
| 学位授与機関識別子 | 15401 | |||||||||
| 言語 | ja | |||||||||
| 学位授与機関名 | 広島大学 | |||||||||
| 学位授与機関 | ||||||||||
| 言語 | en | |||||||||
| 学位授与機関名 | Hiroshima University | |||||||||
| 旧ID | 38667 | |||||||||
