Okada Y, Shima T, Nishida M, Yamada T, Yamane K, Fukui T, Yoshida A
Department of Neurosurgery, Chugoku Rousai Hospital, Kure, Japan.
No To Shinkei. 1990 Jun;42(6):591-6.
Few hemodynamic studies on the vertebral artery system in the human can be seen. The authors measured the vertebral arterial blood flow (VAF) with an electromagnetic flow meter in 45 patients who obtained vertebral arterial surgeries. The patients showing vertebrobasilar insufficiency such as vertigo and drop attack had serious kinking and stenosis at the first portion of the vertebral artery. The effects of induced hypotension by trimethaphan camsilate, induced hypertension by phenylephrine, cervical epidural anesthesia and induced hypertension under epidural anesthesia on the VAF were investigated. During the control state, mean systemic arterial blood pressure (SABP), mean VAF were 97 mmHg and 54 ml/min, respectively. The effects of varied SPBP were analyzed by (delta mean VAF/mean VAF)/(delta mean SABP/mean SABP), (delta V/delta S). The delta mean VAF and delta mean SABP indicated varied mean values of VAF and SABP, respectively. Mean SABP was varied significantly by about 25% in each method. The delta V/delta S in induced hypotension, induced hypertension, epidural anesthesia and induced hypertension under epidural anesthesia were -0.05, 0.07, 0.90 and 0.61, respectively, on the average. Induced hypotension by epidural anesthesia and induced hypertension under epidural anesthesia presented significant changes in mean VAF.(ABSTRACT TRUNCATED AT 250 WORDS)
目前鲜见关于人体椎动脉系统的血流动力学研究。作者使用电磁流量计对45例接受椎动脉手术的患者测量了椎动脉血流量(VAF)。表现为眩晕和猝倒等椎基底动脉供血不足的患者,其椎动脉起始部存在严重的扭曲和狭窄。研究了樟磺咪芬诱发的低血压、去氧肾上腺素诱发的高血压、颈部硬膜外麻醉以及硬膜外麻醉下的高血压对VAF的影响。在对照状态下,平均体动脉血压(SABP)和平均VAF分别为97 mmHg和54 ml/min。通过(平均VAF变化量/平均VAF)/(平均SABP变化量/平均SABP),即(ΔV/ΔS)来分析不同SABP的影响。Δ平均VAF和Δ平均SABP分别表示VAF和SABP的变化均值。每种方法中平均SABP均有显著变化,约为25%。硬膜外麻醉诱发的低血压、硬膜外麻醉下诱发的高血压、硬膜外麻醉以及硬膜外麻醉下诱发的高血压时的ΔV/ΔS平均分别为-0.05、0.07、0.90和0.61。硬膜外麻醉诱发的低血压和硬膜外麻醉下诱发的高血压时平均VAF出现显著变化。(摘要截断于250字)