脑卒中患者急性期下肢深静脉血流动力学变化的研究

The Changes of Hemodynamics of Deep Veins of Lower limb in Patients with Acute Stroke

目的了解急性脑卒中后下肢深静脉血流动力学变化。方法将147例脑卒中患者根据肢体瘫痪程度分为≤3度组和＞3度组;20例椎间盘术后肌力正常、卧床7d的患者为骨科手术对照组;20例年龄匹配的健康者为正常对照组。应用空气容积描记术(PVR)测定各组被检者的最大静脉回流量(MVO)及静脉容积变化(SCV)。结果(1)脑卒中肌力≤3度组患者患肢MVO为(85．43±8．16),较健肢的(94．23±6．22)明显下降(P＜0．01);肌力＞3度组患者患肢MVO为(92．33±6．89),与健肢的(93．51±6．71)间无明显差异(P＞0．05);脑卒中组健肢MVO与正常对照组、骨科手术组比较均无显著性差异(P＞0．05);(2)不同年龄组脑卒中患者MVO间差别无显著性意义(P＞0．05);(3)147例脑卒中患者中1例患肢肿胀,MVO/SCV＜0．50,经彩超证实有近端深静脉血栓形成,其余肢体MVO/SCV均＞0．60,临床无深静脉血栓临床表现。结论急性脑卒中患者肢体严重瘫痪时最大静脉回流量减少。

Objective To investigate the changes of hemodynamics of deep veins of lower limb in acute stroke.Meth- ods According to the limbs paralytic degree,147 patients were divided into two groups:group 1 in which the patients' limbs paralytic degree was less than 3 and group 2 in which the patients' limbs paralytic degree was more than 3.The control group of orthopedics surgery included 20 patients staying in bed for 7 days with normal muscle power.The other control group inclueled 20 age-matched volunteers.The PVR was used for detecting the MaximumVenous Outflow (MVO) in all groups.Results (1) Compared with the MVO of self healthy limbs,the MVO of those in groupl was significantly decreased (P＜0.01);while the MVO of group 2 was not significantly declined compared with the MVO of self healthy limbs (P＞0.05).The MVO in control group and in the group of orthopedics surgery had no difference compared with that in the patients group of healthy limbs (P＞0.05).(2) The MVO of healthy limbs in patients group did not show obvious changes among different age groups (P＞0.05). (3) One patient in the stroke group with severely limb MVO below 50% was found haningdeep venous thrombasis by ultrasound, and the MVO of other limbs were all abore 60% with no signs of deep venous thrombosis.Conclusion The maximum venous outflow of low limb decrease in acute stroke patients with severe paralysis.