冠状动脉搭桥术前后乳内动脉的超声检查

目的：研究冠状动脉搭桥术前后乳内动脉（ＩＭＡ）血流动力学的改变，为临床提供安全可靠的检查方法。方法：５０名ＩＭＡ－冠状动脉前降支（ＬＡＤ）搭桥术的患者于手术前后作了ＩＭＡ的超声检查。测量ＩＭＡ的收缩期峰值与舒张末期流速之比（Ｓ／Ｄ），搏动指数（ＰＩ），阻力指数（ＲＩ），计算舒张期流速时间积分分数（ＤＶＴＩＦ）。将与ＬＡＤ吻合的ＩＭＡ手术前后的测值进行比较，并将术后两侧ＩＭＡ的测值进行比较，作统计学处理。结果：手术前后转流侧ＩＭＡ测值比较，血流动力学发生改变。Ｓ／Ｄ，ＰＩ，ＲＩ及ＤＶＴＩＦ均有显著性差异（Ｐ＜０．０１）。手术后转流侧ＩＭＡ与对侧比较，以上各项血流动力学测值同样有非常显著性差异（Ｐ＜０．０１）。ＩＭＡ的血流由术前的收缩期优势型转变为术后的舒张期优势。结论：超声检查在术前对ＩＭＡ可进行筛选，术后是随访转流血流通畅性可靠的无创方法。

Color Doppler Ultrasonography Assessment of Internal Mammary Artery Flow Dynamics before and after Coronary Artery Bypass Graft

Objective:Color Doppler ultrasonography(CDU)study internal mammary artery(IMA)dynamic changes for left anterior coronary artery bypass graft operation.Methods:50 patients were involved in this study.CDU were performed both before and after the operation.Data of the ratio of peak systolic velocity to end diastolic velocity(C/D),PI,RI and diastolic velocity integral fraction(DVTIF)of the operated IMA were compared with the intact contralateral IMA.Results:Significant changes were found in S/D,RI and DVTIF showing that preoperative systolic dominant pattern turned to post operative diastolic dominant pattern.Conclusion:CDU examination is useful for detect pre operative IMA and follow up coronary artery bypass graft patency.