左乳内动脉转流术后近期通畅性的超声研究  

Assessment of the Left Internal Mammary Artery Graft patency with Ultrasound Early Postoperatively

作　　者：田津[1] 李治安[1] 程颐[1] 何怡华[1] 孙琳[1] 杨娅[1] 

机构地区：[1]首都医科大学附属北京安贞医院超声诊断科,北京市100029

出　　处：《中国超声医学杂志》2012年第6期511-514,共4页Chinese Journal of Ultrasound in Medicine

摘　　要：目的应用冠脉血流显像技术结合外周血管超声评价左乳内动脉转流术后近期桥血管通畅性。方法行左乳内动脉左前降支原位转流术患者75例,于术后1周左右观察乳内动脉桥血管起始段,远段(吻合口近端)、吻合口、远端及近端左前降支。各段均显示清晰者人选。分别测量各段收缩期及舒张期峰值流速及流速一时间积分。并计算舒张期与收缩期峰值流速比,舒张期流速一时间积分分数。依据桥血管及左前降支血流动力学特点将患者分为桥血管通畅组,吻合口狭窄组,竞争性供血组,及远端弥漫性病变组。将后三组桥血管血流参数分别与通畅组比较。结果术后桥血管起始段显示率97.3%,乳内动脉桥血管与自体左前降支吻合口显示率97.3%。71例患者人选分组。吻合口狭窄组及竞争性供血组分别与通畅组比较,桥血管起始段血流参数有显著差异,远段无显著差异。远端弥漫病变组与通畅组比较,桥血管起始段及远段血流参数均有显著差异。结论冠脉血流显像技术可直接显示吻合口,同时显示桥血管与自身冠脉,提供评价桥血管通畅性的直接证据。Objective To access the left internal mammary artery （LIMA） graft early postoperative patency after coronary artery bypass grafting （CABG） by peripheral blood vessel ultrasound combined with color Doppler coronary flow imaging （CDCFI）. Methods 75 patients with CABG were detected, the proximal and distal of the LIMA graft, anastomosis, and proximal and distal LAD were examined. Systolic peak velocity, diastolic peak velocity, systolic ve- locity time integral, diastolic velocity time integral for each segment were measured separately. Calculate the ratio of diastolic and systolic peak velocity（D/S）, and diastolic velocity time integral fraction（DVTIF）. Divide them into groups according to anastomosis stenosis sign, LIMA graft and LAD flow. Contrast their flow parameters. Results The percentage appearance in the proximal segment of LIMA graft after CABG was 97.3%, in anastomosis of graft and LAD was 97.3%. Conclusions CDCFI could reveal the anastomosis of grafts and LAD, and display native coro- nary artery. It could provide the direct evidence to access the patency of the graft.

关 键 词：冠脉血流显像技术 乳内动脉 吻合口 

分 类 号：R654.2[医药卫生—外科学] R445.1[医药卫生—临床医学]