Rafael Sadaba J, Conroy J L, Burniston M, Maughan J, Munsch C
Dept. of Cardio-thoracic Surgery, Yorkshire Heart Centre, The General Infirmary, Leeds and Medical Physics Department, St James' University Hospital, Leeds, UK.
Cardiovasc Surg. 2001 Aug;9(4):378-82. doi: 10.1016/s0967-2109(00)00148-4.
This study was designed to measure the degree to which hand and forearm blood flow is reduced following harvesting of the radial artery in myocardial revascularization surgery and determine whether there is an effect on hand function. Twenty patients who had the radial artery used for myocardial revascularization underwent bilateral blood flow assessment of hands and forearms using Technetium-99m human serum albumin and clinical evaluation of hand function. Mean tissue perfusion in ml/100 ml/min +/- SD was as follows: donor hand 21.9 +/- 5.6, non-donor hand 25.5 +/- 6.1 (P = 0.00043), donor arm (hand and forearm) 17.5 +/- 3.7 and non-donor arm (hand and forearm) 21 +/- 5.1 (P = 0.000681). No clinical evidence of hand claudication was detected. This study suggests that removal of the radial artery reduces the tissue perfusion of the hand and forearm but does not affect hand function in the short term. The use of radial artery grafts in patients at risk of developing peripheral vascular disease should be carefully considered
本研究旨在测量心肌血运重建手术中采集桡动脉后手和前臂血流减少的程度,并确定其是否对手功能产生影响。20例采用桡动脉进行心肌血运重建的患者接受了使用锝-99m人血清白蛋白对手和前臂进行的双侧血流评估以及手功能的临床评估。平均组织灌注量(ml/100 ml/min±标准差)如下:供体手21.9±5.6,非供体手25.5±6.1(P = 0.00043),供体臂(手和前臂)17.5±3.7,非供体臂(手和前臂)21±5.1(P = 0.000681)。未检测到手部间歇性跛行的临床证据。本研究表明,桡动脉的采集会降低手和前臂的组织灌注,但短期内不影响手功能。对于有发生外周血管疾病风险的患者,桡动脉移植物的使用应谨慎考虑。