猪腹主动脉下端及髂总动脉不同程度狭窄引起股总动脉血流动力学变化的比较

Hemodynamic changes of common femoral artery caused by different degrees of abdominal aorta extremity and left common iliac artery stenoses in swine

目的探讨腹主动脉下端、髂总动脉不同程度狭窄引起股总动脉血流动力学变化的差异。方法幼年家猪6只,利用血管夹夹闭腹主动脉下端、左侧髂总动脉侧壁依次造成1/3、1/2、3/4管腔狭窄,记录对应股总动脉血流频谱波形,测算PSV、Vmin、S/D、D/S。分析所有实验数据并进行统计学处理,观察血流参数与狭窄程度的相关性,并比较腹主动脉下端、髂总动脉相同程度狭窄引起股总动脉血流动力学变化的差异。结果超过1/2管腔狭窄时反向波消失,出现持续正向波。PSV与狭窄程度呈线性负相关,D/S在管腔狭窄超过1/3后与狭窄程度呈线性正相关。左侧髂总动脉狭窄时,右侧股总动脉血流参数无显著性变化。髂总动脉狭窄较同等程度腹主动脉狭窄引起股总动脉血流动力学改变显著。结论根据一侧股总动脉血流频谱波形的改变可以推断其上游存在狭窄性病变和反应狭窄下游有效循环血容量的情况,离心脏越远处的分支动脉管腔狭窄引起其下游血流动力学改变越显著。

Objective To study the changes of the common femoral artery haemodynamics caused by different degrees of abdominal aorta extremity and left common iliac artery stenoses in swine. Methods The lateral walls of abdominal aorta extremity or left common iliac artery were pinched with vascular clamp resulting in 1/3, 1/2, 2/3 and 3/4 stenosis by turns in 6 juvenile susscrota domesticas. The parameters of PSV, Vmin, S/D and D/S were obtained in all objects, and common femoral artery and their correlations with degrees of abdominal aorta extremity or left common iliac artery stenoses were confirmed by statistical analysis. Results The backward wave vanished and turned to continuous forward wave when stenoses exceeded 1/2. PSV had significant negative correlation with stenoses degree, D/S had significant positive correlation with stenoses degree when stenoses degree exceed 1/3. The right common femoral artery haemodynamics turned little when the left common iliac artery were pinched. The common femoral artery haemodynamics caused by left common iliac artery stenoses changed more significant than abdominal aorta extremity at the same degree stenoses. Conclusion It can be concluded there is proximal stenosis disease and change of distal effective circulating blood volume according to the Doppler spectrum analysis of right or left common femoral artery. The downstream haemodynamics caused by secondary branch arterial stenosis changes significantly. PSV and D/S are valuable parameters to observe hemodynamic changes.