Wood R F, Nasmyth D G
Transplantation. 1982 May;33(5):547-51. doi: 10.1097/00007890-198205000-00016.
In renal transplantation vascular occlusion is usually diagnosed too late for remedial surgery to be successful. A method of continuous monitoring of renal blood flow would provide evidence of a vascular problem and a chance of saving the graft. In this study directional Doppler ultrasound has been used to investigate arterial stenosis and venous outflow obstruction in a canine autograft model, using the pulsatility index (PI). The results demonstrate increasing PI with venous outflow block (P less than 0.005 at stenoses greater than 88% of venous diameter) and a fall in PI accompanying a progressive reduction in arterial inflow (P less than 0.001 at stenoses greater than 78% of arterial diameter). Identical results were achieved with both handheld and indwelling probes. The changes in the audible Doppler signal have a characteristic quality and the insertion of an indwelling Doppler probe offers a potential means of monitoring allograft blood flow in the immediate postoperative period and differentiating between venous and arterial obstruction.
在肾移植中，血管闭塞通常在诊断时就已为时过晚，补救手术难以成功。一种持续监测肾血流的方法将为血管问题提供证据，并为挽救移植肾提供机会。在本研究中，使用定向多普勒超声，通过搏动指数（PI），对犬自体移植模型中的动脉狭窄和静脉流出道梗阻进行了研究。结果表明，静脉流出道阻塞时PI升高（静脉直径狭窄超过88%时，P<0.005），而随着动脉流入量逐渐减少，PI下降（动脉直径狭窄超过78%时，P<0.001）。手持探头和留置探头均获得了相同的结果。可听多普勒信号的变化具有特征性，插入留置多普勒探头为术后即刻监测同种异体肾血流及区分静脉和动脉梗阻提供了一种潜在手段。
