心底部双期连续性杂音疾病的彩色多普勒血流显像与手术对照

心底部双期连续性杂音疾病的彩色多普勒血流显像与手术对照湖北医科大学附属第一医院姜霞，陈文卫，孙有刚心底部双期连续性杂音系指主要产生于胸骨左缘２～４肋间的杂音。导致这种杂音的心脏及大血管疾病因其临床体征及症状相似鉴别实属不易。本文对４８例经彩色多普勒血...     

肝硬化体循环血流动力学变化及心脏病变分析

目的探讨肝硬化体循环血流动力学变化、心脏病变及其发病机制.方法肝硬化患者27例,正常对照组15例,按肝功能Child分级分类;应用超声Doppler检测体循环血流动力学、心脏收缩及舒张功能(E波、A波、Ev/Av比值).结果与正常对照组相比,静息状态下肝功能B、C级肝硬化患者平均动脉压、外周阻力指数明显降低(P<0.05,P<0.01).肝功能A、B级患者心输出量、心脏指数、左室射血分数明显增加(P<0.05,P<0.01),呈高动力循环状态(P<0.05,P<0.01).而肝功能C级患者心输出量、左室射血分数下降,提示心脏收缩功能损害.肝硬化患者Ev/Av比值显著降低(P<0.01),示左室舒张功能不全.结论晚期肝硬化患者存在肝硬化性心肌病.     

声学造影估价兔肾局部损伤血流灌注的实验研究

目的 :探讨声学造影对异常肾组织血流灌注的评估。方法 :新西兰大白兔 8只 ,肾上极皮质注射无水酒精制备局部肾损伤模型。分别用二次谐波显像及彩色能量多普勒成像 ,观察造影前后局部损伤的位置、范围及回声。结果 :造影后 ,6例明显显影 ,正常肾实质回声增强 ,损伤区的影像无明显增强。彩色多普勒显像损伤区彩色充盈缺失或减弱。造影前后异常与正常肾皮质的视频密度差值分别为 8.37± 4 .2 6和 98.6 1± 8.4 5 (P<0 .0 1)。结论 :声学造影可以提高局部肾损伤的检出率 ,提高对肾局部病变诊断的敏感性和特异性。     

激光多普勒血流计在脑瘤术中的应用

激光多普勒血流计在脑瘤术中的应用张荣伟，张洪俊，解相礼激光多普勒血流计（ｌａｓｅｒ－Ｄｏｐｐｌｅｒｆｌｏｗｍｅｔｅｒ，ＬＤＦ）是根据激光多普勒原理研制的测量微循环血流量的一种仪器．是组织血流量测定的一种新的技术手段，国外学者临床应用效果满意Ｕ·’‘，...     

盆腔静脉曲张症的阴道彩色多普勒血流显像

盆腔静脉曲张症的阴道彩色多普勒血流显像孙有刚，陈文卫，付文瑾，石华，郝力丹，田孝坤盆腔静脉曲张症（ＰｅｌｖｉｃＶａｒｉｃｏｃｅｌｅ）是育龄妇女，尤其是输卵管结扎术后妇女下腹疼痛的原因之一。盆腔静脉造影是确诊ＰＶ的常用方法。随着经阴道彩色多普勒显像（Ｔ...     

小乳腺癌的高频声像图及能量多谱勒血流特征

目的：探讨小乳腺癌的高频声像图及能量多谱勒血流特征,改善超声诊断乳腺肿瘤的血流学标准。方法：对经手术病理证实的41例≤2cm的小乳腺癌高频声像图及能量多普勒血流特点进行回顾性分析,与病理进行部分对照。结果：小乳腺癌的二信声像图特点大多属于“中间型”,少数表现为典型恶性特征;37／41（90．2％）的小乳腺癌其能量多普勒血流具有明显形态学特征,包括穿入性血流、折转血流与分叉血流等。另外脉冲多普勒频谱阻力指数RI＞0．7及峰值的“分叉”现象也具有很好的阳性预告意义。结论：使用高频二维超声结合能量多普勒血流特征及频谱多普勒可以准确地诊断小乳腺癌。     

彩色多普勒超声检测脐带位置异常对围产儿预后的意义

本文对54例临床疑为脐带位置异常者进行彩色多谱勒超声血流显像(CDFI)检测,其检出率98%,对脐带位置异常组与100例正常妊娠组的围产儿进行观察,发现羊水粪染及1分钟Apgar评分≤7者明显高于正常组(p＞0.01,p＜0.05),应用CDFI及时为临床提供诊断依据,对分娩方式的选择及围产儿预后有着重要的临床意义。     

肝硬化体循环血液动力学变化及心脏病变分析

目的　探讨肝硬化体循环血流动力学变化、心脏病变及其发病机制。方法　肝硬化患者 2 7例 ,正常对照组 15例 ,按肝功能Child分级分类 ;应用超声Doppler检测体循环血流动力学、心脏收缩及舒张功能 (E波、A波、Ev/Av 比值 )。结果　与正常对照组相比 ,静息状态下肝功能B、C级肝硬化患者平均动脉压、外周阻力指数明显降低 (P<0 .0 5 ,P <0 .0 1)。肝功能A、B级患者心输出量、心脏指数、左室射血分数明显增加 (P <0 .0 5 ,P <0 .0 1) ,呈高动力循环状态 (P <0 .0 5 ,P <0 .0 1)。而肝功能C级患者心输出量、左室射血分数下降 ,提示心脏收缩功能损害。肝硬化患者Ev/Av 比值显著降低 (P <0 .0 1) ,示左室舒张功能不全。结论　晚期肝硬化患者存在肝硬化性心肌病     

脑动脉硬化症智能障碍患者血流动力学的变化

目的观察脑动脉硬化症智能障碍患者血流动力学的变化,为预防和治疗该病提供客观依据。方法对67例脑动脉硬化症智能障碍患者以韦氏成人智力量表测查后分为三个组观察,另有30例健康体检者做为对照组,分别行经颅多谱勒(TCD)检查,观察血流动力学情况。结果边缘智力组(A组)、轻度损害组(B组)及中度损害组(C组)患者颈内动脉系统动脉平均峰值流速(Vm)显著低于对照组(P<0.05,P<0.01);C组椎基底动脉系统Vm显著低于对照组及A组(P<0.05);A、B、C三组患者血管搏动指数(PI)显著高于正常对照组(P<0.01,P<0.001),B、C组患者PI显著高于正常对照组及A组(P<0.01,P<0.001)。结论脑动脉硬化症智能障碍患者存在广泛的脑血流低灌注,并且病情有随脑血流低灌注程度加重而加重的趋势,TCD检查为预防及治疗脑动脉硬化症智能障碍提供了客观依据。     

Laser Doppler flowmetry for determining changes in cutaneous blood flow following intradermal injection of histamine

The use of laser Doppler flowmetry (LDF) in determining changes in cutaneous blood flow following intradermal injection of histamine has been investigated in this double-blind study. In eight subjects blood flow (LDF) and weal-and-flare area (planimetry) were measured at regular intervals for 1 hr following 50-microliter injections of different concentrations of histamine (6.5 X 10(-5)-6.5 X 10(-3)M) and saline. The mean maximum increase in LDF values over the flare was at least nine-fold greater than the baseline values for all three concentrations of histamine injected. When the LDF values observed at different sites were integrated to obtain the 'LDF response' it was possible to demonstrate concentration-related increases in blood flow and to differentiate clearly between the different concentrations of histamine and saline for up to 30 min after injection. During this period, the repeatability and the time course of the LDF response was comparable with that of the flare area. These studies suggest that the noninvasive technique of LDF is a sensitive and reproducible method for quantifying the changes in cutaneous blood flow that occurs for the first 30 min after intradermal injection of histamine.     

Hepatic and intestinal blood flow following thermal injury

Because cardiac output decreases after burn injuries, investigators have assumed, based upon dye clearance techniques, that hepatic and intestinal blood flow are also decreased following these injuries. Blood flow to the liver, stomach, small intestine, and kidney was determined by the uptake of 201thallium and 125I-labeled fatty acid (para-125I-phenyl-3-methyl pentanoic acid) in a 20% body surface area scald injury that also included plasma volume replacement resuscitation. Uptake of these radioisotopes was determined 15 minutes, 18 hours, and 72 hours after injury. The uptake of the 201thallium and 125I-labeled fatty acid by the gastrointestinal tissues was not statistically different at any of the time periods after comparison of the injured and control (sham-treated) animals. 201Thallium uptake by the kidney was significantly diminished 15 minutes after the burn injury (P less than 0.01). Based on these blood flow measurement techniques, the data suggest that the 20% body surface area scald injury did not alter blood flow to the liver or gastrointestinal tract within the initial 72 hours after the burn injury even though a decrease in renal blood flow was easily detected. These results suggest that the dysfunction of the gastrointestinal system or hepatic system observed after an acute burn injury is not simply the result of hypovolemic shock, which reduces both renal and mesenteric blood flow. These gastrointestinal and hepatic alterations may be related to a factor or factors other than intestinal ischemia.     

Modification of blood flow to the extremities by electrical stimulation of the nervous system.

Sixteen patients who had electrical stimulation applied to various portions of the nervous system were examined for increase in blood flow to the extremities. Clinical observations and a one-channel plethysmograph were used to measure arterial dilatation. Seven patients had transcutaneous stimulation applied over the cervical or thoracic spinal cord, peripheral nerves, or low lumbar region; eight had electrical stimulators implanted over the spinal cord in attempts to relieve intractable pain or some of the symptoms of multiple sclerosis; and one patient had electrical stimulators implanted over the C-6 dorsal roots for small artery disease of the upper extremities. Twelve of 13 patients who had electrical stimulation applied to the spinal cord or dorsal roots had significant arterial dilatation in one or more extremities. Electrical stimulation applied to the ulnar nerves did cause arterial dilatation. One patient did not show any change in the central arterial pressure curve during transcutaneous stimulation of the cervical spinal cord.     

Laser Doppler imaging of changes in cerebral blood flow during acute carotid occlusion.

OBJECTIVE: To determine by laser Doppler imaging (LDI) the spatial and temporal characteristics of the changes in cerebral blood flow (CBF) in response to electrical forepaw stimulation in rats before and during acute unilateral carotid occlusion. BACKGROUND DATA: Single laser Doppler (LD) probes provide a minimally invasive approach for measuring CBF changes due to functional stimulation. Using an electrical forepaw stimulation model in rats, we have previously demonstrated a prolongation in the temporal dynamics of the CBF response during acute mechanical carotid occlusion. However, the spatial resolution of this model system was limited by the diameter of the single LD probe. Recently, we have successfully used LDI, which uses an optically driven low power laser beam to measure CBF changes in two dimensions, to investigate the spatial and temporal changes in CBF due to forepaw stimulation. METHODS: LDI was used to measure the spatial and temporal characteristics of the changes in CBF response in a-chloralose anesthetized rats (n = 5) both before and during acute unilateral occlusion of the common carotid contralateral to the forepaw stimulated. RESULTS: Acute mechanical occlusion of the common carotid contralateral to the forepaw stimulated did not affect the area of activation due to functional stimulation. However, the amplitude of the CBF response was significantly reduced compared to prior to occlusion. Further, acute occlusion led to a significant prolongation of temporal dynamics of the CBF response. These observations are in agreement with previous results we have obtained using a single LD probe. CONCLUSIONS: Our results suggest a promising role for the application of LDI to study the spatial and temporal characteristics of CBF changes in animal models and may allow a diagnostic technique for testing patients with carotid occlusion.     

The effect of transcutaneous electrical nerve stimulation on local and distal cutaneous blood flow following a prolonged heat stimulus in healthy subjects

The aim of this study was to investigate the effects of transcutaneous electrical nerve stimulation (TENS) on blood flow and skin temperature following an elevation of baseline blood flow using infrared preheating. A randomized controlled approach was used whereby 66 healthy human subjects (33 male, 33 female) were allocated to one of three intervention groups (n=22 per group, equal male and female): Control, Low frequency TENS (4 Hz/200 micros), or High frequency TENS (110 Hz/200 micros). TENS was applied just below motor threshold over the median nerve of the right forearm for 15 min immediately following an infrared preheating. Cutaneous blood flow and skin temperature were recorded at 3-min intervals from the forearm and fingertips during TENS and for 15 min following TENS. Analysis of data revealed no significant differences between High and Low frequency TENS for cutaneous blood flow or skin temperature at the forearm. A small and short lived increase in cutaneous blood flow at the index finger was observed on TENS groups compared with control when TENS was switched off. TENS reduced skin temperature when compared to control during the first 9 min of the 15-min stimulation period at the middle finger but not at the index finger. It was concluded that the effects of high and low frequency TENS when applied below motor threshold produced changes in blood flow and skin temperature that were transient and small.