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目的:探讨利多卡因脊髓功能诱发试验在支气管动脉介入治疗术中预防脊髓损伤的作用。方法:常规治疗组肺癌采用支气管动脉灌注化疗术或加栓塞术,大咯血采用支气管动脉栓塞术;利多卡因诱发试验组常规化疗栓塞术同前,术前加用利多卡因脊髓功能诱发试验,即动脉内缓慢注入1%利多卡因3~5ml,判断支气管肋间动脉干有无合并根动脉,阳性者行微导管超选择插管治疗。结果:常规治疗组464例,发生脊髓损伤致瘫6例,占1.3%,利多卡因诱发试验组215例,行诱发试验116例,阳性者37例,无1例患者出现截瘫。两组差异显著(P<0.05)。结论:介入治疗前应用利多卡因脊髓功能诱发试验判断支气管动脉有无合并脊髓根动脉,能有效避免髓动脉损伤致瘫痪的发生。
Objective: To investigate the effect of lidocaine-induced spinal cord injury in prevention of spinal cord injury during bronchial artery interventional therapy. Methods: The routine treatment group received bronchial artery infusion chemotherapy or chemoembolization chemotherapy and massive hemoptysis with bronchial artery embolization. The conventional chemoembolization with lidocaine-induced test group was given the same preoperative and preoperative plus lidocaine spinal cord function test, That is, slowly injected 1% lidocaine intra-arterial 3 ~ 5ml, to determine whether the bronchial artery trunk with or without root artery, the positive line of microcatheter superselective intubation. Results: In 464 cases of conventional treatment group, 6 cases were caused by spinal cord injury (1.3%), 215 cases were induced by lidocaine, 116 cases were induced by induction test, and 37 cases were positive. No patient had paraplegia. The difference between the two groups was significant (P <0.05). Conclusion: The intervention of lidocaine spinal cord function test before intervention to determine whether the bronchial artery with or without spinal cord root artery, which can effectively prevent paralysis caused by spinal cord injury.