@article{oai:air.repo.nii.ac.jp:00001550,
 author = {成田, 卓也 and 山本, 文雄 and 山本, 浩史 and 石橋, 和幸 and 平居, 秀和 and 柳, 克祥 and [ほか] and NARITA, Takuya and YAMAMOTO, Fumio and YAMAMOTO, Hiroshi and ISHIBASHI, Kazuyuki and HIRAI, Hidekazu and LIU, KX},
 issue = {2},
 journal = {秋田医学},
 month = {Sep},
 note = {Background: We reviewed our experiences in order to analyze the
factors causing central neurological dysfunction in thoracic aortic arch surgeries with
antegrade selective cerebral perfusion (ASCP).
Methods: Between October 2000 and September 2003, 76 patients underwent thoracic
aortic surgery with ASCP, comprising 55 men (72.4%) and 21 women (27.6%),
ranging in age from 27 to 86 years (mean 67.8 ± 10.9 years). Thoracic aortic lesions
were identified as aneurysms in 43 patients (56_6%) and dissections in 33 patients
(43.4%). Perioperative factors were analyzed by univariate and multivariate analyse to
identify predictors of transient neurological dysfunction (TND).
Results: Permanent neurological dysfunction (PND) occurred in two patients
(2.6%), as a result of embolism during surgery, and TND in 15 patients (19.7%).
Univariate logistic regression indicated that ruptured aneurysm, hypertension, preoperative
mean blood pressure, history of neurological disease, and operation time had a
significant influence on the indication of TND. Multivariate analysis revealed that
ruptured aneurysm, history of neurological disease and operation time were statistically
significant predictors of TND.
Conclusions: It is suggested that cerebral autoregulation may influence the outcome
of TND, and precise blood pressure control might be an important factor for
maintaing cerebral perfusion.},
 pages = {121--130},
 title = {胸部大血管手術と脳保護  - 選択的脳潅流,周術期管理と術後中枢神経障害の発生 -},
 volume = {31},
 year = {2004}
}