CAJ | 학술논문

目的运用术中超声探讨颌内动脉(IMA)-颅内动脉搭桥的血流动力学特征.方法术中超声测定15例正常IMA、35例IMA-移植桡动脉-大脑中动脉(IMA-RA-MCA)搭桥、7例IMA-移植桡动脉-大脑后动脉(IMA-RA-PCA)搭桥和10例颞浅动脉-大脑中动脉(STA-MCA)搭桥的血流动力学参数,并比较它们之间的差异.结果 IMA与移植RA管径差异无统计学意义[(2.49 ±0.31)mm vs(2.47 ±0.26)mm,P=0.812].正常IMA、IMA-RA-MCA搭桥和IMA-RA-PCA搭桥血流量分别为(81.8±19.0) ml/min、(69.6±16.3)ml/min和(48.0±8.8) ml/min,均明显高于STA-MCA搭桥的(31.0±8.4) ml/min(P值分别为0.000、0.000和0.001).供血动脉(IMA vs STA)和受血动脉(MCA vs PCA)影响桥血管血流量.结论 IMA可作为颅内外动脉搭桥的短距离高流量血流来源,其内径与RA管径匹配可直接行端-端吻合.IMA-RA-MCA/PCA动脉搭桥可向颅内提供中高流量血流.供血动脉和受血动脉影响桥血管血流量.
목적 운용술중초성탐토합내동맥(IMA)-로내동맥탑교적혈류동역학특정.방법 술중초성측정15례정상IMA、35례IMA-이식뇨동맥-대뇌중동맥(IMA-RA-MCA)탑교、7례IMA-이식뇨동맥-대뇌후동맥(IMA-RA-PCA)탑교화10례섭천동맥-대뇌중동맥(STA-MCA)탑교적혈류동역학삼수,병비교타문지간적차이.결과 IMA여이식RA관경차이무통계학의의[(2.49 ±0.31)mm vs(2.47 ±0.26)mm,P=0.812].정상IMA、IMA-RA-MCA탑교화IMA-RA-PCA탑교혈류량분별위(81.8±19.0) ml/min、(69.6±16.3)ml/min화(48.0±8.8) ml/min,균명현고우STA-MCA탑교적(31.0±8.4) ml/min(P치분별위0.000、0.000화0.001).공혈동맥(IMA vs STA)화수혈동맥(MCA vs PCA)영향교혈관혈류량.결론 IMA가작위로내외동맥탑교적단거리고류량혈류래원,기내경여RA관경필배가직접행단-단문합.IMA-RA-MCA/PCA동맥탑교가향로내제공중고류량혈류.공혈동맥화수혈동맥영향교혈관혈류량.
Objective To explore the hemodynamics of internal maxillary artery (IMA)-intracranial arterial bypasses via intraoperative duplex ultrasonography.Methods The hemodynamic parameters (flow volume,inside diameter,mean flow velocity,pulse index and resistance index) were compared between normal IMA (n =15),IMA-radial artery (RA)-MCA (n =35) bypass,IMA-RA-PCA (n =7) bypass and superficial temporal artery(STA)-MCA bypass (n =10) by measuring the flow via intraoperative duplex ultrasonography.Results There was no significant difference in inside diameter between IMA and RA (2.49 ±0.31)mm vs (2.47 ±0.26)mm,P =0.812).The average flow was (81.8 ±19.0)ml/min for normal IMA,(69.6± 163)ml/min for IMA -RA-MCA bypass and (48.0 ± 8.8) ml/min for IMA-RA-PCA bypass,which were significantly higher than that of STA-MCA bypass (31.0 ± 8.4) ml/min (P =0.000,0.000 and 0.001).The donor vessel (IMA vs STA) and recipient vessel (MCA vs PCA) could impact the flow through bypasses.Condusions IMA could deliver a short segment high blood flow as a donor vessel for extracranial-intracranial bypass.The suitable inside diameter of IMA and RA could make an end-to-end anastomosis be performed directly.IMA-RA-MCA/PCA bypasses could supply middle to high flow capacity for brain.The donor vessel and recipient vessel might impact the final blood flow volume through extracranial-intracranial bypass.