妊娠母羊子宫动脉栓塞引起的子宫动脉血流速度波形中舒张期切迹的意义。

Significance of a diastolic notch in the uterine artery flow velocity waveform induced by uterine embolisation in the pregnant ewe.

作者信息

Ochi H, Matsubara K, Kusanagi Y, Taniguchi H, Ito M

机构信息

Department of Obstetrics and Gynaecology, Ehime University School of Medicine, Shigenobu, Japan.

出版信息

Br J Obstet Gynaecol. 1998 Oct;105(10):1118-21. doi: 10.1111/j.1471-0528.1998.tb09946.x.

DOI:10.1111/j.1471-0528.1998.tb09946.x

PMID:9800937

Abstract

OBJECTIVE

To investigate the relation between placental embolisation and the diastolic notch in the uterine artery flow velocity waveform of pregnant ewes under general anaesthesia.

METHODS

Seven pregnant ewes at a gestation 16 to 17 weeks were anaesthesized and microbeads of gelfoam were injected into the uterine artery; changes in the uterine circulation were assessed by Doppler velocimetry.

RESULTS

Gelfoam embolisation reduced uterine blood flow in a dose-dependent manner, from a mean (95%, CI) of 568 mL/min (495-641) to 159 mL/min (131-187) after the injection of 30 mg of gelfoam, and increased the uterine vascular resistance from 135 mmHg x min x L(-1)(103-167) to 498 mmHg x min x L(-1) (422-574). A diastolic notch in uterine artery flow velocity waveform was observed after 20 mg to 25 mg of gelfoam in two ewes and after injection of 30 mg of gelfoam in all seven animals. Injection of 30 mg of gelfoam increased the pulsatility index to 2.4 (1.9-2.9) from 0.6 (0.5-0.7). The mean uterine vascular resistance at the time of the appearance of a diastolic notch was 414 mmHg x min x L(-1)(377-451).

CONCLUSION

These findings suggest that an elevated pulsatility index and the presence of a diastolic notch in the uterine artery flow velocity waveform are indicators of increased uterine vascular resistance and impaired uterine circulation.

摘要

目的

研究全身麻醉下妊娠母羊胎盘栓塞与子宫动脉血流速度波形舒张期切迹之间的关系。

方法

对7只妊娠16至17周的母羊进行麻醉，并将明胶海绵微珠注入子宫动脉；通过多普勒测速法评估子宫循环的变化。

结果

明胶海绵栓塞以剂量依赖方式减少子宫血流，注入30mg明胶海绵后，平均（95%，可信区间）子宫血流从568mL/min（495 - 641）降至159mL/min（131 - 187），子宫血管阻力从135mmHg×min×L⁻¹（103 - 167）增至498mmHg×min×L⁻¹（422 - 574）。两只母羊注入20mg至25mg明胶海绵后以及所有7只动物注入30mg明胶海绵后，子宫动脉血流速度波形均出现舒张期切迹。注入30mg明胶海绵后，搏动指数从0.6（0.5 - 0.7）增至2.4（1.9 - 2.9）。出现舒张期切迹时的平均子宫血管阻力为414mmHg×min×L⁻¹（377 - 451）。