Yamashita H, Hayakawa K, Akagi M
Second Department of Surgery, Kumamoto University School of Medicine, Japan.
Jpn J Surg. 1990 Jan;20(1):1-9. doi: 10.1007/BF02470707.
Clinical studies were performed on 42 patients who underwent femoro-femoral bypass and postoperative assessment of the ankle/brachial pressure index (API) and Doppler waveform for each limb was carried out. Patients who had poor runoff of the donor limb showed a significant decrease in API after ankle joint exercise (p less than 0.05), whereas no significant change was observed in patients who had poor runoff of the recipient limb. The response of pulsatility index was similar to that of API. Thirteen of the 42 patients underwent both pre- and postoperative assessments. Six of these patients underwent additional procedures such as thromboendarterectomy or profundaplasty on the anastomotic site of the donor limb, and the other 7 patients had no additional procedures performed. A decrease in API after exercise was prominent in the patients who had not undergone any additional procedures, in the postoperative stage (p less than 0.01). Thus, when performing femoro-femoral bypass, improving poor runoff in the donor limb by carrying out intraoperative additional procedures should be taken into consideration, as any imbalance of peripheral resistance must be kept to an absolute minimum.
对42例行股-股旁路手术的患者进行了临床研究，并对每个肢体进行了术后踝/臂压力指数（API）和多普勒波形评估。供体肢体血流灌注不良的患者在踝关节运动后API显著降低（p<0.05），而受体肢体血流灌注不良的患者未观察到显著变化。搏动指数的反应与API相似。42例患者中有13例进行了术前和术后评估。其中6例患者在供体肢体吻合部位接受了额外的手术，如血栓内膜切除术或股深动脉成形术，另外7例患者未进行额外手术。在术后阶段，未进行任何额外手术的患者运动后API下降显著（p<0.01）。因此，在进行股-股旁路手术时，应考虑通过术中额外手术改善供体肢体的不良血流灌注，因为必须将外周阻力的任何不平衡保持在绝对最小值。
