Cronestrand R, Brismar B, Jorfeldt L, Juhlin-Dannfelt A
Acta Chir Scand. 1978;144(2):75-81.
Common femoral arterial and bypass blood flows, cardiac output, brachial arterial and central pressures were measured in nine patients undergoing a femoro-popliteal vein bypass graft for intermittent claudication. The measurements were performed during neuroleptanesthesia before the operation, after the operation before blood substitution and then after transfusions of 450,900 and 1350 ml of blood. The leg blood flows were measured before and during local vasodilatation induced by intra-arterial injection of bamethane (Vasculat). The bypass flow was only 55 ml/min before blood substitution but was increased to 215 ml/min after the blood transfusions. The corresponding values for the common femoral artery were 100 ml/min and 430 ml/min, respectively. The maximal flow in the bypass vein during vasodilatation with bamethane (Vasculat) was 145 ml/min before blood substitution and 270 ml/min after the transfusions. This implies that the flow response to vasodilatation was more pronounced before than after blood substitution. The leg blood flow increased proportionally more than cardiac output on blood substitution. It is concluded that leg blood flow is very sensitive to hypovolemia and can be increased considerably by adequate blood substitution. The flow response to local vasodilatation is proportionally higher during hypovolemia.
对9例因间歇性跛行接受股-腘静脉搭桥手术的患者，测量了股总动脉血流、搭桥血流、心输出量、肱动脉压和中心静脉压。测量在术前神经安定麻醉期间、术后未输血前以及输注450、900和1350ml血液后进行。在动脉内注射巴美生（血管扩张剂）诱导局部血管扩张之前和期间测量腿部血流。输血前搭桥血流仅为55ml/min，但输血后增加至215ml/min。股总动脉的相应值分别为100ml/min和430ml/min。在使用巴美生（血管扩张剂）进行血管扩张期间，搭桥静脉的最大血流在输血前为145ml/min，输血后为270ml/min。这意味着血管扩张时的血流反应在输血前比输血后更明显。输血时腿部血流的增加比例大于心输出量。结论是腿部血流对血容量不足非常敏感，通过适当输血可显著增加。血容量不足时对局部血管扩张的血流反应比例更高。
