摘要
目的:应用超声检测技术判断腕部电烧伤后尺、桡动脉病理变化,探讨新的诊断方法。方法:选择腕部高压电击伤患者,用 B 型超声和彩色多普勒检测患者腕创面部、创缘上5 cm、10 cm、15 cm 处的尺、桡动脉内膜、管壁厚度、管腔内径和血流量,并以正常人尺、桡动脉为对照。结果:1、血管内膜的主要病理变化有:内膜粗糙、水肿增厚、内膜脱落。2、管壁呈阶段性增厚,厚度不均,0.05～0.19cm,较正常对照厚约1倍,重者管壁坏死。3、管腔狭窄或扩张,可呈串珠状,创面段和创面上5cm 段狭窄最明显,重者管腔闭塞血栓形成。4、血流量降低,以近创面处明显。5、血管损伤以腕创面部最重,距创面边缘约10～15cm 处血管形态基本接近正常。结论:超声检测可以直观显示受损血管内膜形态变化,管径大小,管壁厚度和血流量,对判断电烧伤血管损伤程度和范围有指导意义,是一种无创、精确、方便的检测方法,值得应用和推广。
Objective:To explore a new method to define the extent and degree of arterial injury in the wrist sus- taining high tension electric burns.Methods:Eighteen patients(twenty four wrists)with high tension electrical injury were admitted from December 1998 to September 2002.The Four sites of the wounded wrists were exam- ined:the wound itself,5 cm,10cm,15cm away from the wound,and the radial and ulnar arteries were examined with B ultrasound and color WP Doppler.The changes in endothelium,vessel diameter,thickness of the vessel wall,and volume of blood flow were recorded respectively.The parameters of normal radial and ulnar arteries were also determined for comparison.Results:B ultrasound and color WP Doppler examinations showed that the endothelial lining in the radial and ulnar arteries became coarse,edematous or exfoliated.The vessel wall was thic- ker than that of the normal controls,and the thickness was not uniform.The vessel wall was necrotic in patient with severe burn,and the vessel lumen was narrowed or beaded.The vessel were thrombosed or occluded in se- vere injury,and a decrease in volume of blood flow was observed.The condition of the radial and ulnar arteries tended to be near normal 10-15 cm away from the wrist wound.Conclusion:The ultrasonography can be used to detect the changes in the endothelium,diameter and thickness of the vessel wall,blood flow volume in injured blood vessel as a result of electric burn injury.The determination of degree and extent of injury vessel is helpful in the operative treatment of the injury,and the methods used appear to be safe and non-invasive,therefore worth popularizing.
出处
《感染．炎症．修复》
2003年第4期209-211,257,共4页
Infection Inflammation Repair
关键词
超声
电烧伤
血管
Ultrasound
Electric burns
Blood vessel
