术前乳内动脉超声检查在冠状动脉旁路移植术中的应用价值  

Value of Preoperative Ultrasonography of Internal Mammary Artery in Coronary Artery Bypass Grafting

作　　者：刘刚[1] 高俊雪 陈彧[1] 陈生龙[1] 史艺 LIU Gang;GAO Junxue;CHEN Yu;CHEN Shenglong;SHI Yi(Department of Cardiac Surgery,Peking University People's Hospital,Beijing 100044,China;Department of Echocardiography,Xiang'an Hospital of Xiamen University,Xiamen 361101,China)

机构地区：[1]北京大学人民医院心外科,北京100044 [2]厦门大学附属翔安医院超声科,厦门361101

出　　处：《中国循环杂志》2023年第5期544-547,共4页Chinese Circulation Journal

基　　金：国家自然科学基金(11832003)。

摘　　要：目的:探讨术前乳内动脉超声检查在冠状动脉旁路移植术中的应用价值。方法:回顾性分析2018年1月1日至12月31日在北京大学人民医院行冠状动脉旁路移植术(CABG)的281例患者临床资料,统计术前乳内动脉超声检查结果,比较左、右乳内动脉的各项超声检查指标(乳内动脉直径、血流量、搏动指数),并结合患者乳内动脉的使用及手术中乳内动脉桥的超声测量结果,进行统计学和临床分析。结果:本研究共纳入281例行CABG的患者,男性210例(74.7%),术前乳内动脉超声显示左、右乳内动脉直径分别为(1.95±0.15)mm和(1.97±0.17)mm(P=0.014),血流量分别为(15.4±5.9)ml/min和(18.2±7.2)ml/min(P<0.001),搏动指数分别为4.12±1.40和3.90±1.19(P<0.001)。术前乳内动脉超声发现乳内动脉血流异常3例。Pearson相关性分析显示原位左乳内动脉血流量与直径相关(r=0.319,95%CI:0.205~0.425,P<0.001),原位左乳内动脉直径、血流量与乳内动脉桥血管血流量不相关(r分别为0.049和0.005,P均>0.05),临床左乳内动脉使用264例,原位使用261例(98.9%);右乳内动脉使用29例,原位使用21例(72.4%)。结论:本研究显示右乳内动脉直径和血流量优于左乳内动脉;术前乳内动脉超声检查可筛选出不宜原位用作桥血管材料的乳内动脉,右乳内动脉的使用方式变化较大。Objectives:To determine the practical value of preoperative internal mammary artery(IMA)ultrasonography in coronary artery bypass grafting(CABG).Methods:Data of patients who received CABG in our center from Jan.1st 2018 to Dec.31st 2018 were reviewed retrospectively.The results of preoperative ultrasound examination of the IMA were analyzed and the correlation between preoperative ultrasound results and flow parameters measured intraoperatively was determined.Results:Data from 281 patients(210 males)who received CABG during the study period were collected.The diameter,flow,and pulse index(PI)of left and right IMA(LIMA and RIMA)were(1.95±0.15)mm and(1.97±0.17)mm(P=0.014),(15.4±5.9)ml/min and(18.2±7.2)ml/min(P<0.001),4.12±1.40 and 3.90±1.19(P<0.001),respectively.Intraoperative measurement found abnormal flow in 3 patients.Pearson correlation analysis showed there was positive correlation between LIMA diameter and in site flow of LIMA(r=0.319,95%CI:0.205-0.425,P<0.001).However,there was no correlation between LIMA diameter,in site flow and LIMA graft flow(P=0.4432 and P=0.9327).29 RIMA were used in 281 CABG patients,and 21(72.4%)of them were used as in site grafts.264 LIMA were used and 261 of them were used as in site grafts.Conclusions:These results show that both the diameter and flow of RIMA is larger than LIMA.Preoperative ultrasonography of IMA could screen out abnormal IMA,and use of RIMA is variable in CABG.

关 键 词：冠状动脉旁路移植术 乳内动脉 超声检查 

分 类 号：R54[医药卫生—心血管疾病]