Pauca A L, Hudspeth A S, Wallenhaupt S L, Tucker W Y, Kon N D, Mills S A, Cordell A R
Department of Anesthesia, Bowman Gray School of Medicine, Wake Forest University Medical Center, Winston-Salem, North Carolina 27103.
Anesthesiology. 1989 Jun;70(6):935-41. doi: 10.1097/00000542-198906000-00009.
To test whether the radial artery-to-aorta pressure gradient seen in some patients after cardiopulmonary bypass (CPB) is due to reduction in hand vascular resistance, the authors compared pressures in the ascending aorta with pressures in the radial artery before and after CPB in 12 patients. They increased hand vascular resistance by briefly occluding the radial and ulnar arteries at the wrist and recorded that effect on the radial artery-to-aorta pressure relationship. They also recorded the effect of wrist compression on radial artery pressures before and after CPB in 38 patients not having aortic pressure measurements. Before CPB in the first 12 patients, the radial systolic arterial pressure (SAP) was significantly higher (P less than 0.05) than the ascending aortic SAP, and wrist compression did not significantly affect that difference (P greater than 0.05). After CPB, the radial artery and aortic SAPs were not statistically different (P greater than 0.05), but wrist compression restored the higher radial artery SAP. The mean arterial pressure (MAP) was equal in four patients and 1-3 mmHg higher or lower in eight patients before CPB, and wrist compression did not alter those relationships. After CPB, MAP was equal in four patients; radial MAP was 1-3 mmHg higher or lower in six patients, and 7 and 10 mmHg lower in the last two patients.(ABSTRACT TRUNCATED AT 250 WORDS)
为了检验在体外循环(CPB)后部分患者出现的桡动脉与主动脉之间的压力梯度是否是由于手部血管阻力降低所致,作者比较了12例患者CPB前后升主动脉压力与桡动脉压力。他们通过短暂阻断手腕处的桡动脉和尺动脉来增加手部血管阻力,并记录其对桡动脉与主动脉压力关系的影响。他们还记录了在38例未测量主动脉压力的患者中,手腕压迫对CPB前后桡动脉压力的影响。在最初12例患者CPB前,桡动脉收缩压(SAP)显著高于(P<0.05)升主动脉SAP,手腕压迫并未显著影响该差异(P>0.05)。CPB后,桡动脉和主动脉SAP无统计学差异(P>0.05),但手腕压迫使桡动脉SAP恢复较高水平。CPB前,4例患者平均动脉压(MAP)相等,8例患者MAP高或低1 - 3 mmHg,手腕压迫未改变这些关系。CPB后,4例患者MAP相等;6例患者桡动脉MAP高或低1 - 3 mmHg,最后2例患者桡动脉MAP分别低7和10 mmHg。(摘要截短至250字)