Clayton J M, Russell H E, Hartford C E, Boyd W C, Barnes R W
Ann Surg. 1977 Apr;185(4):391-6. doi: 10.1097/00000658-197704000-00003.
To assess the hemodynamic alterations in the circumferentially burned extremity, Doppler arterial examinations and Xenon-133 washout determinations of muscle blood flow (MBF) were obtained in 27 limbs. In this laboratory normal resting MBF was 2.82+/-0.86 cc/min/100 gm (mean +/- S.E.M., N=26) with no value less than 1.60 cc/min/100 gm. In 27 circumferentially burned limbs, the maximum decrement in MBF occurred by 36 hours following thermal injury. The lowest MBF value in the 11 extremities not requiring escharotomy was 1.50cc/min/100gm. Escharotomy was done in 16 extremities. Mean MBF immediately prior to escharotomy was 1.30+/-0.26cc/min/100gm and improved to 4.43+/-0.52cc/min/100gm following escharotomy (p less than 0.01). Correlation between MBF and Doppler examinations was present in 63% of all studies and in 88% of studies performed immediately before or after escharotomy. The diagnostic sensitivity of Doppler examination required audible recognition of abnormal velocity signals as well as absent velocity signals. Because the intial MBF determination or Doppler examination is not helpful in predicting which extremities will eventually require escharotomy, sequential studies should be done during the first 36-48 hours following thermal injury.
为评估环形烧伤肢体的血流动力学改变，对27条肢体进行了多普勒动脉检查及肌肉血流量（MBF）的氙-133清除率测定。在本实验室，正常静息MBF为2.82±0.86毫升/分钟/100克（均值±标准误，N = 26），无值低于1.60毫升/分钟/100克。在27条环形烧伤肢体中，MBF的最大降幅发生在热损伤后36小时。11条无需焦痂切开术的肢体中，最低MBF值为1.50毫升/分钟/100克。对16条肢体进行了焦痂切开术。焦痂切开术前的平均MBF为1.30±0.26毫升/分钟/100克，焦痂切开术后升至4.43±0.52毫升/分钟/100克（p < 0.01）。在所有研究中，63%的MBF与多普勒检查存在相关性，在焦痂切开术前或术后立即进行的研究中，这一比例为88%。多普勒检查的诊断敏感性要求能够听到异常速度信号以及无速度信号。由于初始MBF测定或多普勒检查无助于预测哪些肢体最终需要焦痂切开术，因此应在热损伤后的头36 - 48小时内进行连续研究。
