心血管手术时上下肢血压同步监测的比较

A COMPARISON OF BLOOD PRESSURE BETWEEN UPPER AND LOWER LIMBS WITH SYNCHRONOUS MONITORING METHOD DURING CARDIOVASCULAR SURGERY

作者对38例心血管病患者术中上下肢血压作同步监测比较。其中20例心脏病患者分成桡动脉(RA)-股动脉(FA)和RA-足背动脉(DPA)两组,各10例。结果显示,FA压均略高于RA,但两者无显著差异。尽管DPA收缩压略高于RA,舒张压和平均压低于RA,但亦无显著差异。因此,RA、FA和DPA均可作为穿刺测压的选择途径,无需校正。本文对18例主动脉缩窄患者术中RA与FA平均压作了同步监测比较。结果表明,手术前后上下肢血压的差别,可协助判定主动脉缩窄程度和手术效果。

Blood pressures of upper and lower limbs were compared by synchronous monitoring method in 20 cases during open heart surgery. The patients were equally divided into two groups: radial artery vs. femoral artery group (RA-FA group) and radial artery vs. dorsalis pedis artery group (RA-DPA group). The results of RA-FA group showed that FA pressure was slightly higher than RA pressure, but the systolic pressure (r1=0.90), diastolic pressure(r1=0.85) and mean pressure.(r1=0.91)of RA and FA revealed significant correlation (P<0.001).The results in RA-DPA group showed that the systolic pressure of DPA was a little higher than RA, but the diastolic and mean pressure were lower than RA. However, the systolic pressure (r2=0.82), diastolic pressure (r2=0.85) and mean pressure (r2=0.86) of RA and DPA were also closely correlated (P<0.001). The difference between r1 and r2 was not statistically significant (P>0.05). It suggests that RA, FA or DPA could be selected as an approach for arterial puncture and systemic blood pressure monitoring.Synchronous monitorings of mean pressure for RA and FA were also undertaken during operations in 18 cases of aortic coarctation. The difference between RA and FA was very helpful to determine the degree of coarctation and the outcome of surgery.