Guijarro Morales A, Saavedra Garcia O, Marti Garcia J L, Torrededia Homs J, Cano Pérez M, Peláez Redondo J
Arch Inst Cardiol Mex. 1979 Jul-Aug;49(4):673-84.
We studied several parameters of the jugular flebogram in 70 patients who had undergone cardiac surgery. Fifty six of them were on sinusal rithm and 14 in auricular fibrillation. We found among them 39 who had undergone commissurotomy and 16 who had got valvular prothesis. The results of these studies were analyzed and compared with those of 94 normal subjects, taking in consideration the type of surgical intervention and the time elapsed since the operation was performed--the latter in the more numerous group. It is interesting to observe that the sinus grows deeper after the intervention so making the relation xv/yv lower than the unit in 33% of the patients maintaining sinusal rithm. This alteration remained stationary during some years in some of the cases, the results suggesting a greater frequency during the first months of the post-operatory period. We didn't find any relation of this morphologic alteration with the presence of a pericardial construction, pulmonary hypertension, valvular injuries with repercussion on the right heart or modifications on the nenous pressure which we think due to functional changes following the pericardiotomy. It is interesting to observe these mechanographic signs in relation with the post-operatory period of cardiac surgery, but we must avoid hypervaluation of those cases suspicious of pericardial constriction.
我们研究了70例接受心脏手术患者的颈静脉搏动图的几个参数。其中56例为窦性心律,14例为心房颤动。我们发现其中39例接受了二尖瓣分离术,16例植入了人工瓣膜。对这些研究结果进行了分析,并与94名正常受试者的结果进行了比较,同时考虑了手术干预的类型以及手术完成后的时间——后者在人数较多的组中。有趣的是,观察到干预后窦变得更深,从而使33%维持窦性心律的患者中xv/yv比值低于单位值。在某些情况下,这种改变在几年内保持稳定,结果表明在术后最初几个月更为频繁。我们没有发现这种形态学改变与心包结构、肺动脉高压、对右心有影响的瓣膜损伤或神经压力改变之间存在任何关联,我们认为这些改变是由于心包切开术后的功能变化所致。观察这些与心脏手术后时期相关的力学征象很有趣,但我们必须避免对那些疑似心包缩窄的病例过度评估。