中国组织工程研究

中国组织工程研究 ›› 2010, Vol. 14 ›› Issue (31): 5853-5855.doi: 10.3969/j.issn.1673-8225.2010.31.038

• 器官移植临床实践 clinical practice of organ transplantation • 上一篇    下一篇

左乳内动脉冠状动脉旁路移植患者原位与游离状态的流量测定

宋  峥，李德才，刘春晓，张海洲，张文龙，王正军，訾  捷   

  1. 山东大学附属省立医院心血管外科，山东省济南市  250021
  • 出版日期:2010-07-30 发布日期:2010-07-30
  • 通讯作者: 李德才，副教授，山东大学附属省立医院心血管外科，山东省济南市 250021 decaili@hotmail.com
  • 作者简介:宋 峥★，男，1983年生,河南省平顶山市人，汉族，山东大学医学院在读硕士，主要从事冠状动脉疾病研究。 szhaijie@sina.com

Flow measurement of in situ and free-state left internal mammary artery in patients undergoing coronary artery bypass grafting

Song Zheng, Li De-cai, Liu Chun-xiao, Zhang Hai-zhou, Zhang Wen-long, Wang Zheng-jun, Zi Jie   

  1. Department of Cardiovascular Surgery, Provincial Hospital Affiliated to Shandong University, Jinan  250021, Shandong Province, China
  • Online:2010-07-30 Published:2010-07-30
  • Contact: Li De-cai, Associate professor, Department of Cardiovascular Surgery, Provincial Hospital Affiliated to Shandong University, Jinan 250021, Shandong Province, China decaili@hotmail.com
  • About author:Song Zheng★, Studying for master’s degree, Department of Cardiovascular Surgery, Provincial Hospital Affiliated to Shandong University, Jinan 250021, Shandong Province, China szhaijie@sina.com

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495

被引次数

2

摘要：

背景：左乳内动脉旁路移植以疗效可靠、远期通畅率高而成为冠心病外科治疗的首选和标准技术。但左乳内动脉是否合适行序贯吻合及序贯血管的血流量是否能满足人体需要一直存在争议。
目的：探讨接受非体外循环下左乳内动脉冠状动脉旁路移植患者左乳内动脉原位与游离状态的血流量之间的差别。
方法：选择2008-03/2009-03接受非体外循环下左乳内动脉冠状动脉旁路移植患者56例，术中先游离出左乳内动脉近端一小段无蒂光滑区，待循环稳定后，利用即时血流检测仪先进行左乳内动脉原位血流测定，再将左乳内动脉所有侧支完全离断，在远端离断之前，进行左乳内动脉原位游离状态的流量测定。
结果与结论：56例冠心病患者左乳内动脉主干原位血流明显好于游离状态的主干原位血流[(32.0±5.0)，(10.0±1.2) mL/min, P < 0.01]，表明左乳内动脉主干血流与其分支数目有关；左乳内动脉具有一定的流量储备，可为冠脉搭桥序贯吻合提供理论依据。

关键词: 冠状动脉疾病, 乳内动脉, 流量测定, 器官移植, 冠状动脉旁路移植

Abstract:

BACKGROUND: Left internal mammary artery (LIMA) bypass graft has become first choice and standard technique for coronary artery disease, which has reliable efficacy and long-term patency. However, the question whether sequential anastomosis is appropriate to LIMA and the sequential vessel blood flow is adequate for human body remains controversial.
OBJECTIVE: To explore the differences in blood flow between in situ and free state of LIMA in patients with the coronary artery disease (CAD) undergoing off-pump coronary artery bypass grafting.
METHODS: Between March 2008 and March 2009, 56 patients with CAD who had undergone off-pump coronary artery bypass grafting with LIMA bypass grafts were selected. A pedicle-free smooth segment of proximal LIMA was dissociated during surgery. LIMA’s in situ blood flow was measured when the hemodynamics stabilized. When the branch of LIMA was completely dissociated, the free state blood flow was measured.
RESULTS AND CONCLUSION: The in situ mean flow of 56 patients was significantly better than free state flow [(32.0±5.0), (10.0±1.2) mL/min, P < 0.01]. Results show that the blood flow of LIMA is related with the number of branching vessel and the LIMA has the ability of flow reservation, which provides theoretical evidence for coronary artery bypass grafting sequential anastomosis.

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