肱动脉血流动力学和掌温检测在胸交感神经干切断术中的临床意义  

Clinical significance of intraoperative palmar temperature and brachial artery blood flow monitoring during sympathectomy

作　　者：涂远荣[1] 李旭[1] 林敏[1] 赖繁彩[1] 陈剑锋[1] 陈玲[2] 叶建刚[1] 代祖建[1] 

机构地区：[1]福建医科大学附属第一医院胸外科,福州350005 [2]福建医科大学附属第一医院超声影像科,福州350005

出　　处：《中华胸心血管外科杂志》2006年第6期369-370,共2页Chinese Journal of Thoracic and Cardiovascular Surgery

基　　金：福建医科大学科研项目资助(FJGXQ04006)

摘　　要：目的探讨超声检测肱动脉血流动力学变化和手掌测温在胸交感神经干切断术治疗手汗症的应用价值。方法对150例手汗症病人分别于胸交感神经干切断术前与术后测量手掌皮温,并对其中33例行双侧肱动脉超声血流动力学指标检测。结果全组术后平均掌温升高(2·8±1·0)℃,其中125例平均掌温显著升高(3·24±0·20)℃,25例升高不显著,仅(0·64±0·10)℃。术毕超声检测肱动脉血管内径增大,血流量显著增多,收缩期峰值与舒张期终末值均变大,搏动指数变小,收缩期/舒张期比值显著变小,行配对t检验显示,以上参数P值均<0·05,差异有统计学意义。结论术中超声检测肱动脉血流动力学变化,结合掌温测量是判断胸交感神经干切断成功的有效方法。Objective Assess the value of intraoperative palmar temperature and brachial artery blood flow monitring during sympathectmy. Methods 150 cases palmar hyperhidrosis underwent transthoracic endoscopic sympathectomy. Palmar temperature was all monitored and brachial artery blood flow is also detected by ultrasonography 33 cases. Results Palmar temperature increase （2.8± 1.0）℃ after sympathefic chain has been destroyed [（include a high level increase of （3.24±0.20）℃ in 125 cases and a low level increase of （ 0.64 ± 0.12） ℃ in 25 cases]. Ultrasonography indicate brachial artery radius （R） and blood flow volume （VOL） are significantly increased, Maximum （Vmax） and Minimum （Vmin） speed of blood flow at systole and diastole, pulse index （PI） and systole/diastole blood flow ratio （S/D） are also increased （ P 〈0.05）. Conclusion Intrapoerative palmar temperature and brachial blood flow monitring are effective in demonstrating that sympathectic chain has been destroyed during sympathectomy.

关 键 词：多汗症 交感神经切除术 肱动脉 

分 类 号：R655[医药卫生—外科学]