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目的 :探讨强直性脊柱炎 (AS)脊柱后凸矫正术的适应症与主动脉钙化的关系。方法 :① 6例新鲜尸体主动脉按 10 %、15 %、2 0 %、2 5 %、30 %和 35 %牵拉后的力学变化 ,用压力换能器在生理二道记录仪上记下压力值 ,作组织切片 ,光镜观察 ;② 30例高血压主动脉钙化硬化病人在核磁共振下动态由弯腰变伸直进行弯腰试验 ;③ 41例AS合并主动脉钙化患者 ,脊柱后矫正前后行X线观察主动脉与椎体相对位移情况。结果 :主动脉受牵拉超过原长的 2 0 %会产生血管损伤 ,而牵拉在 15 %以内则无血管损伤 ;弯腰试验主动脉与椎体无移位 ;主动脉钙化者 ,矫正术后均未发现主动脉损伤征象。结论 :对AS脊柱后凸合并主动脉钙化患者 ,只要术中对主动脉的牵拉限制在 2 0 %以内脊柱矫形术是安全的。术中采用控制性低血压可以增加主动脉顺应性。
Objective: To investigate the relationship between the indications of aortic kyphosis and the indications of ankylosing spondylitis (AS) kyphosis. Methods: ① The mechanical changes of 6 fresh cadaver aortas were pulled by 10%, 15%, 20%, 25%, 30% and 35% Pressure value, for tissue sections, light microscopy; ② 30 patients with hypertensive aortic calcification sclerosis patients under dynamic magnetic resonance bending down bending test; ③ 41 cases of AS patients with aortic calcification, posterior correction of the spine Before and after X-ray observation of the relative displacement of the aorta and vertebral body. Results: 20% of the aorta was pulled by more than the original length of the blood vessel injury, while the traction within 15% of the no vascular damage; bend the aorta and vertebral body no shift; aortic calcification, orthodontic No signs of aortic injury were found. CONCLUSION: For patients with AS kyphosis and aortic calcification, spine orthopedics are safe as long as intraoperative aorta traction is limited to 20%. Intraoperative control hypotension can increase aortic compliance.