Hyytinen T A, Halme M
Department of Thoracic and Cardiovascular Surgery, Helsinki University Central Hospital, Finland.
Scand Cardiovasc J. 2000 Jun;34(3):345-9. doi: 10.1080/713783117.
Healing of tracheal anastomosis after en bloc double-lung or heart-lung transplantation was analysed with the aid of endoscopic laser Doppler flowmetry in 7 patients (group I) with successful bronchial artery revascularization (BAR) and in 5 patients (group II) without or with failed BAR. Fifteen patients undergoing coronary surgery served as a control group. Airway anastomotic index (AAI) was used to express the ratio of Doppler flowmetry values between donor and recipient airway. On postoperative day 1 the mean (range) AAI was 1.3 (1.1-1.6) in group I, 0.74 (0.25-1.0) in group II and 0.95 (0.7-1.4) in the controls.The difference was statistically significant between groups I and II (p = 0.01) and also between group I and the control group (p = 0.003). Two group II patients had low AAI (<0.5), and both developed airway anastomotic complications. We conclude that successful BAR increases blood flow in the airway anastomotic region, and that low AAI on the first postoperative day is a strong predictor of late airway anastomotic complications.
借助内镜激光多普勒血流仪，对7例（第一组）支气管动脉血运重建（BAR）成功的全肺或心肺移植患者及5例BAR未成功或失败的患者（第二组）的气管吻合口愈合情况进行了分析。15例接受冠状动脉手术的患者作为对照组。气道吻合指数（AAI）用于表示供体和受体气道之间多普勒血流仪测量值的比值。术后第1天，第一组的平均（范围）AAI为1.3（1.1 - 1.6），第二组为0.74（0.25 - 1.0），对照组为0.95（0.7 - 1.4）。第一组和第二组之间差异有统计学意义（p = 0.01），第一组与对照组之间差异也有统计学意义（p = 0.003）。第二组有2例患者AAI较低（<0.5），且均出现了气道吻合口并发症。我们得出结论，成功的BAR可增加气道吻合区域的血流，术后第1天AAI较低是晚期气道吻合口并发症的有力预测指标。
