| Japanese |
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| Title | 下行胸部大動脈瘤に対する人工血管置換術後の対麻痺にナロキソン投与が有用であった一症例 |
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| Subtitle | 症例 |
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| Authors | 鍛治正範*, 奥谷龍*, 植木隆介*, 平井康純*, 野間秀樹*, 太城力良*, 和田虎三**, 八百英樹** |
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| Authors(kana) | |
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| Organization | *兵庫医科大学病院集中治療部, **兵庫医科大学胸部外科 |
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| Journal | 循環制御 |
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| Volume | 22 |
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| Number | 4 |
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| Page | 384-387 |
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| Year/Month | 2001/ |
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| Article | 報告 |
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| Publisher | 日本循環制御医学会 |
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| Abstract | 「要旨」症例は56歳男性で, 多発性下行胸部大動脈瘤に対して人工血管置換術が施行された. 術直後より完全対麻痺と第9胸脊髄レベル以下の知覚鈍麻を認めたため, 脳脊髄液ドレナージおよびステロイド(メチルプレドニゾロン1000mg)の静脈内投与に加え, 脊髄の血流改善効果目的でナロキソンの持続静注療法(1μg・kg-1・h-1)を開始した. 以後, 速やかに対麻痺は消失し, 術後2日目にICUを退室した. MRI検査で脊髄前角に梗塞像を認めたが, 何ら神経学的障害を残すことなく無事退院できた. 「はじめに」下行胸部大動脈瘤に対する人工血管置換術の術後合併症として脳梗塞と脊髄の循環障害に伴う対麻痺が報告されている1). 近年, ナロキソンの脊髄血流改善効果は, 臨床症例での予防的投与の有用性2)や, 動物実験3)でも実証されている. 今回, 著者らは胸部下行大動脈人工血管置換術後発症した対麻痺に対し, ナロキソンの持続的静脈内投与を行うことで症状の改善をみた症例を経験したので報告する. |
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| Practice | 基礎医学・関連科学 |
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| Keywords | Naloxone, Paraplegia, Repair for thoracic aortic aneurysm |
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| English |
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| Title | Naloxon Improved Postoperative Paraplegia Caused by Replacement of Thoracic Aortic Aneurysm |
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| Authors | Masanori Kaji*, Ryu Okutani*, Ryusuke Ueki*, Yasuzumi Hirai*, Hideki Noma*, Chikara Tashiro*, Torazo Wada**, Hideki Yao** |
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| Authors(kana) | |
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| Organization | *Department of Intensive Care Unit Hyogo College of Medicine Hospital, **Department of Thoracic Surgery Hyogo College of Medicine Hospital |
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| Journal | Circulation Control |
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| Volume | 22 |
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| Number | 4 |
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| Page | 384-387 |
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| Year/Month | 2001/ |
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| Article | Report |
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| Publisher | Japan Society of Circulation Control |
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| Abstract | A 56-year-old male who was diagnosed multiple descending thoracic aneurysm, underwent reconstruction of aneurysm. Immediately after surgery, paraplegia and hypesthesia below the 9th thoracic dermatome were noted. In order to increase the spinal blood flow, continuous intravenous naloxon infusion at a rate of 1 μg/kg/hr was started, in addition to 1000 mg of intravenous methylprednisolone. Thereafter the symptoms were improued quickly and paraplegia was disappeared. In magnetic resonance imaging, infarction was objected in spinal anterior horn cell, but any neurological disorder was not seen postoperatively. He could discharge the Intensive Care Unit two days after surgery. |
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| Practice | Basic medicine |
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| Keywords | Naloxone, Paraplegia, Repair for thoracic aortic aneurysm |
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