彩色多普勒血流成像评价周围动脉旁路转流术后人造血管狭窄的因素

Evaluating the influence factors of peripheral artery prosthetic bypass grafts stenosis with color Doppler flow imaging

目的应用彩色多普勒血流成像(CDFI)评价周围动脉旁路转流术移植血管长度和术后时间与人造血管发生狭窄的关系,为临床正确选择手术适应症,有目的地控制狭窄的发生提供简单快捷、准确、可重复的检查手段。方法将35例行周围动脉旁路转流术的患者共37条人造血管按不同术式分短距离和长距离移植两组,应用CDFI观测术后时间≤1年、1年<术后≤3年人造血管发生狭窄情况。结果CDFI能够显示人造血管管壁、管腔内情况,判定狭窄部位和程度;人造血管狭窄与术式和术后时间有关,长距离人造血管移植组发生狭窄的比率(9/16)高于短距离移植术组(5/20)(P<0.05),动脉旁路移植术后≤1年人造血管发生狭窄的比率(11/14)明显高于术后1～3年(3/14)(P<0.05);人造血管狭窄多发生远心端吻合口处(9/14)。结论CDFI是评价人造血管的准确、可信赖的方法。人造血管发生狭窄与人造血管长度和术后时间有密切关系。

Objective To correlate the bypass grafts stenosis with the length of bypass grafts and postoperative intervals by color Doppler flow imaging （CDFI）, and to provide a reliable technique for selecting operation indications and for controlling stenosis of the grafts. Methods Thirty-five patients underwent bypasses because of artery occlusion, 37 bypass grafts were divided into two groups： long-distance bypass grafts and short-distance bypass grafts according to the different operation. Stenotic degrees of bypass grafts were evaluated with CDFI in 41 year cases and in 1--3 years cases postoperatively. Results The endovascular characterizations and stenosis of the bypass grafts could be detected clearly by CDFI. The bypass grafts stenosis had relation to operation and postoperative intervals. There were significant differences of bypass grafts stenosis incidence between long-distance bypass grafts group （9/16） and short-distance bypass grafts group （5/20） （P〈0.05）, and between postoperative intervals in the cases 41 year （11/14） and in the cases of 1--3 years （3/14）（P〈0.05） ; The bypass grafts stenosis happened at the distal anastomosis （9/14）. Conclusion CDFI is an accurate and reliable method for evaluating the bypass grafts. The length of bypass grafts and the postoperative intervals played important roles in the bypass grafts stenosis.