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下肢动脉缺血患者小腿肌肉中的组织气体张力。

Tissue gas tensions in the calf muscles of patients with lower limb arterial ischaemia.

作者信息

Jussila E, Niinikoski J, Inberg M V

出版信息

Scand J Thorac Cardiovasc Surg. 1979;13(1):77-82. doi: 10.3109/14017437909101791.

Abstract

O2 and CO2 tensions were measured in the gastrocnemius muscles of patients submitted for reconstructive arterial surgery due to obstructive arteriosclerosis (37) or abdominal aortic aneurysm (5). Four patients without signs of arterial ischaemia served as controls. Measurements were carried out by means of implanted silastic tonometers during breathing of air and 100% O2 and immediately after walking on a treadmill. Peripheral blood pressures in the ankles were recorded with a Doppler apparatus. Baseline tissue gas tensions showed no essential differences between the various groups of patients: intermittent claudication, pain at rest, praegangrene, abdominal aortic aneurysm and controls. In contrast, baseline ankle pressures correlated well with the severity of the disease. During breathing of oxygen, the smallest increases of muscle PO2 were observed in extremities with pain at rest or praegangrene and the highest responses were recorded in controls and aneurysm patients. Muscle PCO2 values showed no alterations during oxygen breathing. In physical exercise, muscle PO2 and PCO2 levels as well as ankle blood pressures remained unchanged in controls and patients with aneurysm but no claudication. However, in all groups with arterial ischaemia, the exercise test resulted in a profound fall of muscle PO2 and ankle blood pressure and an increase of muscle PCO2.

摘要

对因阻塞性动脉硬化(37例)或腹主动脉瘤(5例)而接受重建性动脉手术的患者的腓肠肌进行了氧分压(O2)和二氧化碳分压(CO2)的测量。选取4例无动脉缺血迹象的患者作为对照。在患者呼吸空气和100%氧气时以及在跑步机上行走后立即,通过植入的硅橡胶张力计进行测量。用多普勒仪器记录踝部的外周血压。各组患者(间歇性跛行、静息痛、坏疽前期、腹主动脉瘤患者及对照组)的基线组织气体张力无本质差异。相比之下,基线踝部血压与疾病严重程度密切相关。在呼吸氧气期间,在有静息痛或坏疽前期的肢体中观察到肌肉PO2的增加最小,而在对照组和动脉瘤患者中记录到的反应最高。在呼吸氧气期间,肌肉PCO2值无变化。在体育锻炼中,对照组和有动脉瘤但无跛行的患者的肌肉PO2和PCO2水平以及踝部血压保持不变。然而,在所有有动脉缺血的组中,运动试验导致肌肉PO2和踝部血压大幅下降,肌肉PCO2升高。

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