摘要目的 运用术中超声探讨颌内动脉(IMA)-颅内动脉搭桥的血流动力学特征.方法 术中超声测定15例正常IMA、35例IMA-移植桡动脉-大脑中动脉(IMA-RA-MCA)搭桥、7例IMA-移植桡动脉-大脑后动脉(IMA-RA-PCA)搭桥和10例颞浅动脉-大脑中动脉(STA-MCA)搭桥的血流动力学参数,并比较它们之间的差异.结果 IMA与移植RA管径差异无统计学意义[(2.49 ±0.31)mm vs(2.47 ±0.26)mm,P=0.812].正常IMA、IMA-RA-MCA搭桥和IMA-RA-PCA搭桥血流量分别为(81.8±19.0) ml/min、(69.6±16.3)ml/min和(48.0±8.8) ml/min,均明显高于STA-MCA搭桥的(31.0±8.4) ml/min(P值分别为0.000、0.000和0.001).供血动脉(IMA vs STA)和受血动脉(MCA vs PCA)影响桥血管血流量.结论 IMA可作为颅内外动脉搭桥的短距离高流量血流来源,其内径与RA管径匹配可直接行端-端吻合.IMA-RA-MCA/PCA动脉搭桥可向颅内提供中高流量血流.供血动脉和受血动脉影响桥血管血流量.

abstractsObjective To explore the hemodynamics of internal maxillary artery (IMA)-intracranial arterial bypasses via intraoperative duplex ultrasonography.Methods The hemodynamic parameters (flow volume,inside diameter,mean flow velocity,pulse index and resistance index) were compared between normal IMA (n =15),IMA-radial artery (RA)-MCA (n =35) bypass,IMA-RA-PCA (n =7) bypass and superficial temporal artery(STA)-MCA bypass (n =10) by measuring the flow via intraoperative duplex ultrasonography.Results There was no significant difference in inside diameter between IMA and RA (2.49 ±0.31)mm vs (2.47 ±0.26)mm,P =0.812).The average flow was (81.8 ±19.0)ml/min for normal IMA,(69.6± 163)ml/min for IMA -RA-MCA bypass and (48.0 ± 8.8) ml/min for IMA-RA-PCA bypass,which were significantly higher than that of STA-MCA bypass (31.0 ± 8.4) ml/min (P =0.000,0.000 and 0.001).The donor vessel (IMA vs STA) and recipient vessel (MCA vs PCA) could impact the flow through bypasses.Condusions IMA could deliver a short segment high blood flow as a donor vessel for extracranial-intracranial bypass.The suitable inside diameter of IMA and RA could make an end-to-end anastomosis be performed directly.IMA-RA-MCA/PCA bypasses could supply middle to high flow capacity for brain.The donor vessel and recipient vessel might impact the final blood flow volume through extracranial-intracranial bypass.