CAJ | 학술논문

目的总结慢性肾下腹主动脉闭塞患者的手术治疗及术中下肢血运观察情况.方法回顾性分析2004年1月至2011年12月中国医科大学附属第一医院血管外科行外科手术治疗的36例慢性肾下腹主动脉闭塞性疾病患者的临床资料.术中对患者不同时间点通过各种方法对下肢血运进行观察.结果术中各重要时间点足趾血氧饱和度(血流阻断前82％±6％；血流阻断后为23％±4％；解除阻断后1 min即恢复至66％±5％；关腹完成时为88％ ± 8％)、多普勒探测仪足背、胫后动脉波形均有明显变化.结论多普勒血流探测仪与血氧饱和度仪为简便、无创、客观的探测肢体血运的方法,二者配合使用可提高手术安全性.肢体的保暖和抗血管痉挛药物的使用,可促进血管重建后血运的恢复.
목적 총결만성신하복주동맥폐새환자적수술치료급술중하지혈운관찰정황.방법 회고성분석2004년1월지2011년12월중국의과대학부속제일의원혈관외과행외과수술치료적36례만성신하복주동맥폐새성질병환자적림상자료.술중대환자불동시간점통과각충방법대하지혈운진행관찰.결과 술중각중요시간점족지혈양포화도(혈류조단전82％±6％；혈류조단후위23％±4％；해제조단후1 min즉회복지66％±5％；관복완성시위88％ ± 8％)、다보륵탐측의족배、경후동맥파형균유명현변화.결론 다보륵혈류탐측의여혈양포화도의위간편、무창、객관적탐측지체혈운적방법,이자배합사용가제고수술안전성.지체적보난화항혈관경련약물적사용,가촉진혈관중건후혈운적회복.
Objective To summarize the surgical therapy and profiles of lower limb blood flow during surgery for chronic infrarenal aortic occlusion.Methods A total of 36 patients of chronic infrarenal aortic occlusion underwent surgical procedures at our department from 2004 to 2011.Their clinical data were analyzed.Several methods were applied at different time points during surgery to observe the lower limb blood flow.Results SaO2,waveforms of dorsalis pedis artery and posterior tibial artery changed dramatically at different time points during surgery.Before and after blood occlusion,the SaO2 was 82％ ±6％ and 23％ ±4％ respectively,1min after unclamped and after abdomen-closing,the SaO2 increased to 66％ ± 5％ and 88％ ± 8％ respectively.Conclusion Doppler blood flow and blood oxygen saturation monitors are simple,non-invasive and objective detection methods for lower limb blood flow.A combination of both methods can improve the safety of surgery.Keeping the limbs warm and uses of spasmolytic drugs can facilitate the recovery of postoperative blood flow of lower limbs.