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[采用分期动态经皮血氧测定法评估下肢闭塞性动脉硬化症II期的血管再通过程:15例患者的前瞻性研究]

[Evaluation of the revascularization process by staged dynamic transcutaneous oximetry in stage II of obliterative arteriopathy of the lower limbs: a prospective study of 15 patients].

作者信息

Bouroz-Joly J, Perez-Cousin M, Beregi J P, Hachulla E, Chambon J P, Hatron P Y, Devulder B

机构信息

Service de médecine interne, hôpital Claude-Huriez, Lille, France.

出版信息

Rev Med Interne. 1997;18(11):849-54. doi: 10.1016/s0248-8663(97)81958-3.

Abstract

We evaluated the value of dynamic transcutaneous oxygen tension measurement in 15 patients with Leriche stage II intermittent claudication treated with vascular bypass procedures. Fifteen men, median age 60 years (range: 37-72 years), were studied during six months; 19 limbs were revascularized: eight by angioplasty, 11 by patent graft. Claudication perimeter and dynamic transcutaneous oxygen tension measurement were evaluated before and after revascularization. The TcPO2 was continuously measured with a multimodular Kontron Supermon at seven different sites simultaneously: precordium (reference probe), thighs, calves and feet, in the dorsal recumbent position after 30 minutes rest, during a standardized exercise stress test at 50 W and during the recovery phase. The results were expressed as index of surface defect (ISD). After revascularization, the duration of significant ischemia was significantly reduced (P < 0.001 thigh, calf, foot) in 14 patients. Dynamic transcutaneous oximetry therefore seems to be a useful method in assessing stage II occlusive peripheral arterial disease and the topography of tissue hypoxia. Dynamic transcutaneous oximetry is helpful in the surveillance after revascularization and guides the choice of specific treatment (angioplasty or patent graft) especially for multiple lesions.

摘要

我们评估了动态经皮氧分压测量在15例接受血管搭桥手术治疗的勒里什II期间歇性跛行患者中的价值。对15名男性进行了为期6个月的研究,他们的年龄中位数为60岁(范围:37 - 72岁);19条肢体进行了血运重建:8条通过血管成形术,11条通过通畅的移植物。在血运重建前后评估了跛行周长和动态经皮氧分压测量。使用多模块康强超级监测仪在七个不同部位同时连续测量经皮氧分压(TcPO2):心前区(参考探头)、大腿、小腿和足部,在休息30分钟后的仰卧位、50瓦的标准化运动应激试验期间以及恢复阶段。结果以表面缺陷指数(ISD)表示。血运重建后,14例患者的明显缺血持续时间显著缩短(大腿、小腿、足部P < 0.001)。因此,动态经皮血氧测定似乎是评估II期闭塞性外周动脉疾病和组织缺氧部位的一种有用方法。动态经皮血氧测定有助于血运重建后的监测,并指导特别是对于多发病变的具体治疗(血管成形术或通畅移植物)的选择。

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