Agerskov K
Cardiovasc Res. 1982 Jun;16(6):304-7. doi: 10.1093/cvr/16.6.304.
The effect of circulatory arrest of the calf and foot and head-up tilt upon pressure gradient over the thigh and distribution of muscle blood flow in the thigh was studied in 14 patients with occlusion of the superficial femoral artery. In the supine position circulatory arrest just below the knee initially reduced the directly measured mean arterial pressure gradient over the thigh by about 30% indicating that a similar proportion of total leg blood flow supplied the calf and foot. Local muscle blood flow was measured by the local 133Xe washout technique proximally and distally in the thigh muscle. Total leg blood flow was measured by an indicator dilution technique. During 10 min of circulatory arrest of the calf and foot local muscle blood flow in the thigh increased by approximately 35% proximally and distally. Total leg blood flow remained unchanged and the pressure gradient was reduced by about 10% as compared with that before tourniquet. During head-up tilt local muscle blood flow in the thigh decreased by about 30% proximally and distally. Total leg blood flow also decreased by about 30%. Circulatory arrest below the knee did not alter this response. These findings indicate that blood flow change uniformly in the thigh during head-up tilt and during tourniquet on the calf. Furthermore blood flow to the calf appears only to account for 30% of the arterial pressure drop over the collateral arteries in the thigh, indicating that thigh blood flow is of major importance for the pressure gradient over the collateral arteries.
对14例股浅动脉闭塞患者研究了小腿和足部循环阻断以及头高位倾斜对大腿压力梯度和大腿肌肉血流分布的影响。在仰卧位时，膝关节下方的循环阻断最初使大腿上直接测量的平均动脉压梯度降低约30%，这表明小腿和足部的总腿部血流中约有相同比例供应。通过局部133Xe洗脱技术在大腿肌肉的近端和远端测量局部肌肉血流。通过指示剂稀释技术测量总腿部血流。在小腿和足部循环阻断10分钟期间，大腿近端和远端的局部肌肉血流增加了约35%。总腿部血流保持不变，与止血带使用前相比，压力梯度降低了约10%。在头高位倾斜期间，大腿近端和远端的局部肌肉血流减少了约30%。总腿部血流也减少了约30%。膝关节下方的循环阻断并未改变这种反应。这些发现表明，在头高位倾斜期间和小腿使用止血带期间，大腿血流均匀变化。此外，小腿的血流似乎仅占大腿侧支动脉上动脉压降的30%，这表明大腿血流对侧支动脉上的压力梯度至关重要。
