心内直视术期间经食管彩色多普勒超声探测左肾动脉血流动力学变化

应用经食管彩色多普勒超声仪研究４９例心内直视术期间左肾动脉（ＬＲＡ）的血流动力学变化。结果发现，ＬＲＡ的内径在体外循环（ＣＰＢ）前、中、后无显著性变化，但ＣＰＢ前左肾血流量（Ｑ）较正常人少，血管阻力指数（ＲＩ）较正常人大。ＣＰＢ中，Ｑ增加而ＲＩ降低（Ｐ＜０．０１）。ＣＰＢ后，心脏开始重新做功时，Ｑ较ＣＰＢ前约增加３５％，而ＲＩ进一步升高（Ｐ＜０．０１）．手术失败患者的ＬＲＡ彩色多普勒图像显示不满意。结果表明：经食管彩色多普勒超声作为一种无创性技术，在心内直视术期间检测ＬＲＡ血流，对于判断整个手术过程中ＬＲＡ血流动力学变化，评判手术效果具有一定的实用价值。

Measurement of left arteriorenal hemodynamics changes during intracardiac operation under direct vision by transesophageal color Doppler imaging

The left arteriorenal(LRA) hemodynamics changes in 49 cases during intracardiac operation under direct vision were studied by transesophageal color Doppler imaging.We found that the diameter(D)of LRA was changeless obviously before,during and after cardiopulmonary bypass(CPB).But before CPB ,the volume of blood flow(Q)of LRA was smaller and the resistive index(RI)was larger than that in normal subjects.During CPB,Q was increased and RI brought down.After CPB,the heart started to do work again,Q was increased by about 35% as compared with before CPB and RI added further.In some failing operated cases,the color Doppler imaging of LRA was obscure.The results suggest that the transesophageal color Doppler imaging,as a noninvasive technique,for measurement of the blood flow of LRA and judgement of the operative effect during intracardiac operation under direct vision,is of practical value.