Warwick D, Martin A G, Glew D, Bannister G C
University of Bristol, England.
J Bone Joint Surg Br. 1994 Nov;76(6):918-21.
We examined ten femoral veins with duplex ultrasound during total hip replacement to demonstrate the operative manoeuvres which cause venous obstruction and to assess prophylactic measures which may overcome it. Exposure of the acetabulum by distraction of the femur with a hook was less likely to occlude flow than retraction with bone levers. Adequate exposure of the femoral shaft by adduction, flexion and either internal or external rotation caused cessation of flow in all cases. In four cases an A-V Impulse System foot pump was activated during periods of stasis. In each case it overcame the obstruction and produced peak velocities which were twice that of the resting state. In five cases, towards the end of the procedure, debris was seen travelling proximally through the femoral vein.
我们在全髋关节置换术中使用双功超声检查了10条股静脉，以展示导致静脉阻塞的手术操作，并评估可能克服这种阻塞的预防措施。用钩子牵拉股骨来暴露髋臼，与用骨杠杆牵拉相比，血流被阻断的可能性较小。通过内收、屈曲以及内旋或外旋充分暴露股骨干，在所有病例中均导致血流停止。4例在血流停滞期间启动了动静脉脉冲系统足泵。在每例中，它都克服了阻塞，并产生了是静息状态下两倍的峰值流速。5例在手术接近尾声时，可见碎片向近端通过股静脉移动。
