在心脏外科手术患者的手臂梯度
Yvon Baribeau1, Benjamin M Westbrook, David C Charlesworth
1Department of Cardiac Surgery, Catholic Medical Center and New England Heart Institute, Manchester, NH 03102, USA. baribeau@nhheart.com
Circulation
|October 2, 2002
概括
在心脏手术前,手臂血压的差异表明心血管和大动脉疾病的风险增加. 建议进行手术前成像,以确定这些风险.
科学领域:
- 心血管外科心血管外科
- 血管医学 血管医学
- 诊断成像 诊断成像 诊断成像
背景情况:
- 对手臂之间的血压差异进行手术前评估对于心脏手术患者至关重要.
- 了解手臂血压梯度的临床影响可以为手术规划和风险分层提供信息.
研究的目的:
- 为了研究手术前手臂血压梯度与动脉和近道主动脉动脉样硬化病的存在之间的关联.
- 为了确定手臂血压梯度是否是心脏手术患者中脑血管事件或死亡率的预测指标.
主要方法:
- 一项前性研究,将53名手臂血压梯度患者 (第一组) 与175名没有手臂血压梯度患者 (第二组) 的患者进行比较.
- 所有患者都接受了手术前的动脉双重检查和手术期间的上心脏扫描.
- 风险因素,动脉狭窄和大动脉疾病严重程度在各组之间进行了比较.
主要成果:
- 腕梯度患者 (第一组) 的外周血管疾病 (P<0.0001) 和脑血管症状 (P=0.0196) 发生率显著更高.
- 在第一组 (41.5%) 与第二组 (13.7%) (P<0.0001) 相比,严重的动脉狭窄 (>80%) 在第一组更为普遍.
- 在第一组 (39.6%) 和第二组 (10.8%) (P<0.0001) 中,严重的近端大动脉疾病也更常见.
结论:
- 一个手术前的手臂血压梯度作为一个显著的标志物,用于增加动脉和近道动脉样性大动脉疾病.
- 在手术前的动脉多普勒检查和手术后的上心房超声波强烈推给手臂梯度的患者.
- 建议在导管治疗期间考虑进行手术前的门研究,以进行全面的风险评估.
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