原位BIMA在冠状动脉旁路移植术中的围术期血流研究

Zhou Zhao, Li-xue Zhang, Guo-dong Zhang, Xiangui Zhang, Xuan Wang, Junxue Gao, G. Fan, B. Lian, Jing Liu, Gang Liu, Shenglong Chen, Yu Chen
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引用次数: 0

摘要

目的观察原位双侧乳腺内动脉在冠状动脉旁路移植术(CABG)患者围手术期的血流变化趋势,并比较LIMA和RIMA的血流参数。方法2016年8月至2019年1月在我院行双侧IMA CABG患者57例,男50例,女7例,平均年龄(57.8±10.1)岁。CABG前行经胸超声检查IMA。术中TTFM测量并记录血流量、脉搏指数等参数。结果LIMA和RIMA的平均直径和PI无显著差异,但RIMA的术前流量更高(P=0.026)。TTFM记录LIMA和RIMA的平均血流和PI无显著差异(P<0.05),但LIMA移植血管的舒张血流(DF)高于RIMA移植血管(P=0.022)可能与不同的目标部位有关(P<0.05)。与IMA的术前血流和PI相比,LIMA和IMA的术中血流和PI更好(P<0.001)。结论与IMA术前的血流情况相比,LIMA和IMA的血流情况均较好。尽管目标存在差异,但TTFM记录的LIMA接枝和RIMA接枝的平均流量和PI无显著差异。关键词:乳腺内动脉;冠状动脉旁路移植术;渡越时间流量计;经胸动脉超声
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Perioperative study of blood flow of in-situ BIMA in coronary artery bypass grafting
Objective To observate the changing trend of flow of in-situ bilateral internal mammary artery as grafts during perioperative period in patients undergoing coronary artery bypass grafting(CABG), and to compare the parameters of flow between LIMA and RIMA. Methods A total of 57 patients , 50 males and 7 femails, mean aged(57.8±10.1) years, underwent bilateral IMA CABG in our hospital from August 2016 to January 2019. Transthoracic ultrasound of IMA examination was performed before CABG. The blood flow, the PI(pulsation index) and other parameters were measured and recorded by intraoperative TTFM. Results There was no significant difference of the average diameter and PI between LIMA and RIMA, but the preoperative flow of RIMA is higher(P=0.026) in our study. There was no significant difference of the average flow and PI between LIMA and RIMA recorded by TTFM(P>0.05), but the higher diastolic flow(DF) in LIMA grafts(P=0.022) compared with RIMA grafts may be associated with the different target sites(P<0.05). Compared with the preoperative flow and PI of IMA, the intraoperative flow and PI of both LIMA and RIMA grafts were better(P<0.001). Conclusion Compared with the preoperative flow of IMA, both flow of LIMA and RIMA are better. In spite of the targets exist difference , there are no significant difference of the average flow and PI between LIMA graft and RIMA graft recorded by TTFM. Key words: Internal mammary artery; Coronary artery bypass grafting; Transit-time flowmeter; Transthoracic arterial ultrasound
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