62例冠状动脉旁路移植术中旁路血流量测定  

Transient-time flow measurement in coronary artery bypass graft--report of 62 Cases

作　　者：林冬群[1] 林宇[1] 胡佳心[1] 陈晓伟[1] 周汉槎[1] 阮新民[1] 

机构地区：[1]广东省中医院加州心脏中心,广州510105

出　　处：《岭南心血管病杂志》2006年第1期7-9,共3页South China Journal of Cardiovascular Diseases

摘　　要：目的总结冠状动脉旁路移植术术中旁路血流量测定,说明瞬时血流测定(transient-time flow measurement)的有效性和重要性。方法停跳或不停跳冠状动脉旁路移植术62例,在完成远近端血管吻合后,在血流动力学稳定的情况下应用瞬时流量测定仪(medi-stim butterfly flowmetre)行旁路流量测定,测定平均流量(mean flow,Qm)、搏动指数(pulsatility index,PI)和逆向血流百分比(diastohc backflow,％Insuf),并记录流量曲线。结果 62例手术旁路176根,流量为(23±10)ml／min,PI为3．8±1．7,逆向血流百分比(8± 7)％。其中有1例左冠状动脉优势型术中测得左前降支(left anterior descending artery,LAD)旁路Qm为2 ml／min、PI为33．3,术后发生心绞痛,另2例术中测得旁路Qm小于2 ml／min、PI大于20,经重新吻合后Qm 大于10 ml／min、PI小于5。结论瞬时血流量测定有助手术医生及时发现和纠正移植血管存在的问题。防止术后心肌梗死发生,有助于判断手术预后。Objectives Translent-time flow measurement in coronary artery bypass graft is important in judging the quality of anastomosis. The usfullness and importance of transit-time flow measurement could be revealed by summarizing the flow measurement of 62 cases in the article. Methods The grafts of the 62 cases were measured by Medi-Stim Butterfly Flowmetre for transient flow quality after anastomosis had been finished and stable dynamics had been attained. The parameters included： mean flow（Qm）,pulsatility index（PI）, diastolic baekflow（%Insuf） and flow curve. Results 176 grafts were set up in the 62 cases, the Qm was （23±10）ml/min, PI was（3.8±1.7）, %Insuf was （8±7）. Angina happened in one of the patients who was left coronary dominante, Qm of his LAD graft was 2 ml/min and PI was 33.3. Two grafts whose Qm and PI were found to be less than 2 ml/min and more than 20 respectively,were done and changed to Qm〉10 ml/min, PI 〈 5. Conclusions Transient-time flow measurement is a simple, fast and reliable method by which the patency of grafts could be evaluated. It could help surgeon to find and correct impotency, prevent perioperation infarction, and estimate the prognosis.

关 键 词：冠状动脉旁路移植术 血流量 搏动指数 测定 

分 类 号：R654.2[医药卫生—外科学]