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经激光多普勒血流仪测量,股腘动脉重建术后闭塞后反应性充血值的变化。

Changes in postocclusive reactive hyperaemic values as measured with laser Doppler fluxmetry after infrainguinal arterial reconstructions.

作者信息

Wahlberg E, Olofsson P, Swendenborg J, Fagrell B

机构信息

Department of Surgery Karolinska Hospital, Stockholm, Sweden.

出版信息

Eur J Vasc Endovasc Surg. 1995 Feb;9(2):197-203. doi: 10.1016/s1078-5884(05)80090-5.

Abstract

OBJECTIVES

The aim of the present study was to evaluate microcirculartory changes of the postocclusive reactive hyperaemia test measured with Laser Doppler fluxmetry to detect results of arterial reconstructions.

DESIGN

Prospective open study.

SETTING

Vascular laboratory of a University Hospital.

MATERIAL

Sixty patients with peripheral arterial occlusive disease who underwent infrainguinal reconstruction were examined the day before and 1-2 days after surgery.

CHIEF OUTCOME MEASURES

The values were obtained during postocclusive reactive hyperaemia induced by release of a 3 min arterial occlusion with a cuff at ankle level with the laser Doppler probe placed dorsally on the first toe. The alterations after surgery in these hyperaemia parameters were compared to changes in ankle/brachial index and clinical improvement at 30 days postoperatively.

MAIN RESULTS

Patients improved by surgery according to ankle/brachial index had significantly reduced time to peak (p < 0.001) and significantly increased resting flux value (p < 0.05) and peak flux value (p < 0.05). There was a significant correlation between the change after surgery in time to peak flux and increment of ankle/brachial index (r = 0.63, p < 0.001).

CONCLUSIONS

Changes in reactive hyperaemia values as measured with laser Doppler fluxmetry, especially the time to peak flux, seem to detect circulatory changes caused by arterial reconstructions.

摘要

目的

本研究旨在评估通过激光多普勒血流仪测量的闭塞后反应性充血试验的微循环变化,以检测动脉重建的结果。

设计

前瞻性开放性研究。

地点

大学医院的血管实验室。

材料

60例接受腹股沟下重建的外周动脉闭塞性疾病患者在手术前一天以及术后1 - 2天接受检查。

主要观察指标

在通过脚踝水平的袖带阻断动脉3分钟后松开,诱导闭塞后反应性充血期间,使用激光多普勒探头置于第一趾背侧获取相关数值。将这些充血参数术后的变化与术后30天的踝肱指数变化及临床改善情况进行比较。

主要结果

根据踝肱指数显示手术改善的患者,其达到峰值的时间显著缩短(p < 0.001),静息血流值显著增加(p < 0.05),峰值血流值显著增加(p < 0.05)。术后达到峰值血流时间的变化与踝肱指数的增加之间存在显著相关性(r = 0.63,p < 0.001)。

结论

用激光多普勒血流仪测量的反应性充血值的变化,尤其是达到峰值血流的时间,似乎能检测出动脉重建引起的循环变化。

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