【摘要】 目的　研究人体四肢动脉伤端端吻合术后血流动力学变化，为评价临床修复效果及近、远期疗效提供依据。方法　应用多谱勒超声仪对２１ 例患者的２７ 条端端吻合术后血管的通畅情况进行随访观察。应用受约束弹性管模型，在体测量流量波形，分析吻合血管的血流动力学特性。结果　术后早期２７ 条血管全部通畅，２１ 例患者中１５ 例获半年以上随访，血管均通畅。与健侧对照，术后每搏血流量（ＳＶ）下降，吻合口处血流平均速度（Ｖｍ）升高，壁面剪应力（τ） 下降，但各血管吻合口处与近、远端血管及健侧血管之间差异无显著性意义（ Ｐ ＞ ０．０５）。无论随访时间≤２４ 周或＞２４ 周的患者，其上、下肢血管吻合口处的Ｖｍ 均较健侧升高，ＳＶ 降低，τ下降，但差异无显著性意义（Ｐ ＞ ０．０５） 。两时间组的血流搏动指数（ＰＩ） 间差异无显著性意义（ Ｐ ＞ ０．０５）。随访时间≤２４ 周者，Ｖｍ 高于术后时间＞ ２４ 周者，ＳＶ 及τ均降低，但两时间组之间差异无显著性意义（ Ｐ ＞ ０．０５）。结论　血流动力学参数与血管壁面剪应力是辅助评价血管损伤吻合修复效果的良好参数指标，定期、连续观测有助于预测吻合修复血管的转归。更多还原

【Abstract】 Objective\ To investigate the hemodynamics in human extremities following repair of injuried arteries by end to end anastomosis,in order to evaluate and anticipate the outcome of vascular repair. Methods\ A clinical analysis was undertaken to evaluate the vessel pulsatility index and wall shear stress in repair of the arterial injuries by end to end anastomosis. The records of 21 patients with 27 arterial injuries repaired by end to end anastomosis were reviewed. Results\ All repaired arteries were patent in the early postoperative period. 15 patients were followed up beyond half a year. The blood flow volume (SV) decreased, the mean blood velocity (Vm) through the anastomosed vessels increased and the mean vascular wall shear stress (τ) decreased compared with those of the control side. However, there was no significant difference between the anastomosed vessels and the control side ( P >0.05).These parameters changed at different time groups (≤24 weeks or >24 weeks), but there was no significant difference of pulsatility between the two time groups ( P >0.05). The Vm at time group 1 (24 weeks) was higher than that at time group 2(>24 weeks), the SV and τ both decreased, but there also was no significant difference between the two time groups ( P >0.05). Conclusion\ The hemodynamic factors and the mean vascular wall shear stress were useful parameters for the evaluation of the effect of vascular repair. Periodical and continuous observations are helpful for predicting the outcome of vascular anastomosis repair.更多还原