Coleridge-Smith P D, Hasty J H, Scurr J H
Department of Surgery, University College and Middlesex School of Medicine, UK.
Br J Surg. 1990 Sep;77(9):1055-9. doi: 10.1002/bjs.1800770933.
The mechanisms underlying the development of postoperative deep vein thrombosis remain to be fully elucidated. Previous studies have suggested that peroperative venous distension may be a factor associated with venous thromboembolism. In this study we have obtained high resolution ultrasound images of gastrocnemius and posterior tibial veins in 62 patients undergoing a range of general surgical procedures. From these we determined the changes in vein diameter occurring during the operative procedures, in response to induction of anaesthesia, and after completion of surgery. Veins showed no evidence of dilatation in response to the induction of anaesthesia, but by the end of the operative procedure showed distension of 22-28 per cent. Distension was most prominent in the gastrocnemius veins, and lesser distension was observed in the posterior tibial veins. In a series of patients who received an infusion of 1 litre of saline in addition to basal requirements, distension was 57 per cent compared with 22 per cent in the corresponding control group. Intraoperative venous distension is associated with factors that lead to deep vein thrombosis and may be involved in the mechanisms which result in the commencement of deep vein thrombosis.
术后深静脉血栓形成的潜在机制仍有待充分阐明。先前的研究表明，术中静脉扩张可能是与静脉血栓栓塞相关的一个因素。在本研究中，我们获取了62例接受一系列普通外科手术患者的腓肠肌和胫后静脉的高分辨率超声图像。据此我们确定了手术过程中、麻醉诱导时以及手术结束后静脉直径的变化。静脉在麻醉诱导时未显示扩张迹象，但在手术结束时显示扩张了22% - 28%。扩张在腓肠肌静脉中最为显著，在胫后静脉中观察到的扩张程度较小。在一系列除基础需求量外还输注1升生理盐水的患者中，扩张率为57%，而相应对照组为22%。术中静脉扩张与导致深静脉血栓形成的因素相关，并且可能参与了导致深静脉血栓形成起始的机制。
