冠状动脉搭桥术前后内乳动脉血液动力学评价  

Evaluation on the Hemodynamics of the Left Internal Mammary Artery Preoperative and Postoperative Coronary Artery Bypass Graft

作　　者：李京宏[1] 刘燕辉[1] 华场 段春[2] 凌晨[2] 

机构地区：[1]首都医科大学宣武医院心血管外科,北京市100053 [2]首都医科大学宣武医院超声科,北京市100053

出　　处：《中国超声医学杂志》2002年第10期739-741,共3页Chinese Journal of Ultrasound in Medicine

摘　　要：目的 :应用彩色多普勒超声检测评价冠状动脉架桥术 (CABG)前后左侧内乳动脉 (LIMA)桥的血液动力学变化。方法 :选择 5.0～ 1 2 .0 MHz超宽频线阵探头 ,对 42例 (男性 32例 ,女性 1 0例 ,年龄 42～ 78岁 ,平均 62 .3± 9.4岁 ) CABG采用 LIMA桥治疗的患者 ,分别检测 LIMA的管径、峰值流速 (PSV)、舒张末流速(EDV)、血管阻力指数 (RI)和收缩 /舒张流速比值 (S/ D) ,比较手术前后血液动力学参数的变化。结果 :(1 )手术前后 LIMA多普勒频谱明显改变 ,由术前的收缩峰高尖的阻力型转变为术后舒张期流速升高的相对低阻型血流频谱 ;(2 )术后 EDV明显升高 ,术前 7.79± 4.85cm/ s,术后 1 7.4± 1 0 .35cm/ s(P=0 .0 0 0 )。PSV、RI和 S/ D比值下降 (P=0 .0 0 1 ,P=0 .0 0 0 ,P=0 .0 0 0 )。结论 :术后 LIMA舒张末流速的升高、 RI和 S/ D减低的相对低阻力型血液动力学的变化 ,是评价 LIMA桥通畅的重要指标 ,CDFI是 CABG术后检测Objective:To evaluate the hemodynamic changes of the left internal mammary artery (LIMA)preoperative and postoperative coronary artery bypass graft(CABG)with color Doppler flow imaging(CDFI).Methods:Using 5 0～12 0MHz ultra wide frequency linear transducer of CDFI,we examined the LIMA of 42 cases(male 32,female 10,aged from 42 to 78 years,mean age,62 3±9 4)with pre and postoperative CABG.The diameter,Peak systolic and diastolic velocities(PSV and EDV),resistance index(RI)and ratio of PSV/EDV (S/D)of LIMA were estimated and compared pre and psotoperatively.Results:(1)The blood flow waveform was significantly changed.We saw the characteristics of LIMA transformed from systolic hith resistannce flow type to the low resistance waveform after having been a coronary artery graft.(2)We also found a significant increase of EDV from 7 79±4 85cm/s to 17 4±10 35cm/s( P =0 000)and a significant decrease of PSV?RI and ratio of S/D respectively( P =0 001, P =0 000, P =0 000).Conclusions:The hemodynamic characteristics of the LIMA is an inportant standard to estimate the functional status of LIMA after CABG.CDFI may be used as a creditable method to assess the function of LIMA after CABG.

关 键 词：彩色多普勒超声 冠状动脉架桥术 内乳动脉 血液动力学 

分 类 号：R654.2[医药卫生—外科学]