Henneken V, Bischoff-Everding C, Frank J, Scholz U, Hennig E, Hepp W
Chirurgische Klinik, UKRV/Charlottenburg, FUB, Berlin.
Vasa Suppl. 1992;36:42-7.
Between February 1989 and June 1991 the peripheral outflow resistance was measured at 45 patients during infragenual bypass surgery. In order to find out whether there is a correlation between successful bypass grafting and measured outflow resistance, all patients were controlled regularly. There was a significant difference in mean resistance between those grafts remaining patent and those that failed. 8 out of 11 bypasses, that failed up to one month after operation, had measured peripheral resistance higher than 1.1 mmHg x min/ml. 12 out of 15 bypass grafts remained patent for more than one month and had an outflow resistance less than 0.55 mmHg x min/ml. There is no definite correlation between a measured outflow resistance from 0.55 to 1.1 mmHg x min/ml because of the low number of patients in this group. The purpose of resistance measurement during peripheral vascular surgery was to determine a final value for a decision, if additional surgical or non surgical treatment for a better runoff is necessary. In our study this value is 1.1 mmHg x min/ml. Additional treatments are the peripheral AV-fistula and a jump- or sequential-graft. Another possibility is the intra- and postoperative application of Prostaglandin, which is in an experimental study in our clinic.
1989年2月至1991年6月期间,对45例患者在膝下旁路手术中测量了外周流出阻力。为了确定成功的旁路移植与测量的流出阻力之间是否存在相关性,对所有患者进行了定期监测。移植血管保持通畅者与失败者之间的平均阻力存在显著差异。术后1个月内失败的11例旁路手术中,有8例测量的外周阻力高于1.1 mmHg×min/ml。15例旁路移植血管中有12例通畅超过1个月,流出阻力小于0.55 mmHg×min/ml。由于该组患者数量较少,0.55至1.1 mmHg×min/ml的测量流出阻力之间没有明确的相关性。外周血管手术中测量阻力的目的是确定一个最终值,以决定是否需要额外的手术或非手术治疗以获得更好的血流。在我们的研究中,这个值是1.1 mmHg×min/ml。额外的治疗方法是外周动静脉瘘和跳跃式或序贯式移植。另一种可能性是在术中及术后应用前列腺素,这在我们诊所正在进行实验研究。