【摘要】 目的:探讨彩色多普勒超声图像对电烧伤血管损伤评估的临床应用价值。方法:选择2001-03/2006-02广西医科大学第一附属医院收治的17例上肢高压电烧伤患者的20条尺、桡动脉作为烧伤组,术前应用彩色多普勒超声观察患肢腕部创面及创面近心端8,15cm处尺、桡动脉的管壁厚度、管腔内径、收缩期峰值流速以及血栓形成等情况,并以该病例组正常上肢为对照。术中观察动脉大体改变,出现栓塞或管壁坏死者予以切除并进行组织病理学检查。结果:17例全部进入结果分析。①彩色多普勒超声显示烧伤组18条尺动脉和15条桡动脉出现不同程度的异常,表现为血管内膜水肿,管壁增厚,管腔狭窄或串珠样改变,血流缓慢,甚至血栓形成。②术中所见及组织病理学检查结果与彩色多普勒超声诊断相符。③桡动脉烧伤侧创伤处以及创缘近心端8cm处血管管壁厚度大于对照侧[(0.71±0.02),(0.41±0.08)mm;(0.70±0.02),(0.48±0.12)mm;P=0.000];创缘近心端8,15cm处收缩期峰值流速小于对照侧[(48.363±5.327),(55.304±7.401)cm/s,P=0.003;(52.053±4.797),(63.356±11.237)cm/s;P=0.000]。④尺动脉烧伤侧创伤处以及创缘近心端8cm处血管管壁厚度大于对照侧[(0.68±0.03),(0.40±0.06)mm;(0.59±0.01),(0.48±0.09)mm;P=0.000];创伤处、创缘近心端8,15cm处收缩期峰值流速小于对照侧(P<0.01)。结论:彩色多普勒超声检测技术具有无创性的特点,图像能够准确显示血管的形态学及血液动力学的改变,可为电烧伤患者血管损伤检测中一种理想的检测手段之一。更多还原

【Abstract】 AIM: To explore the utility of color Doppler ultrasonography in the evaluation of vascular injury in patients inflicted with electric burn. METHODS: Totally 20 ulnar arteries and 20 radial arteries in 17 patients with high voltage electric injury of upper limbs admitted by First Affiliated Hospital of Guangxi Medical University from March 2001 to February 2006, were enrolled in the study as burn group while the other healthy upper extremities as the controls. The vascular wall thickness, inner diameter, systolic peak velocity and endovascular thrombosis formation of ulnar and radial arteries at wound sites and in regions 8 cm and 15 cm proximal to the wounds were examined by preoperative color Doppler ultrasonography. The changes of the arteries were evaluated during operation. Thrombotic and/or necrotic vessels were excised and verificated by histopathological examination. RESULTS: A total of 17 patients were involved in the result analysis. ①Color Doppler ultrasonograms showed different degrees abnormal signs, as swelling of endovascular membrane, thickening of vascular wall, lumen stenosis, pearl-cluster-like intermittence and decreased blood flow, and even thrombosis, in 18 ulnar and 15 radial arteries in burn group. ②Observation during operation and postoperative histopathological findings were consistent with color Doppler ultrasonic diagnostic. ③Vascular wall thickness at wound sites and in regions 8 cm proximal to the wounds of radial artery was larger than that in the control sides [(0.71±0.02),(0.41±0.08) mm;(0.70±0.02),(0.48±0.12) mm;P =0.000]. Systolic peak velocity in regions 8 cm and 15 cm proximal to the wounds was slower than that in control side [(48.363±5.327),(55.304±7.401) cm/s,P =0.003;(52.053±4.797),(63.356±11.237) cm/s;P =0.000]. ④Vascular wall thickness at wound sites and in regions 8 cm proximal to the wounds was larger than that at control side [(0.68±0.03),(0.40±0.06) mm;(0.59±0.01),(0.48±0.09) mm;P =0.000]. Systolic peak velocity at wound sites and in regions 8 cm and 15 cm proximal to the wounds was slower than that at control side (P < 0.01). CONCLUSION:Color Doppler ultrasonography is characterized by non-invasive effect. The image can exactly display the changes of vascular morphology and haemodynamics. It is one of ideal screening tests for the vascular injuries in patients with electric burn.更多还原