Abstract: 【Abstract】....Objective...To discuss the role of the mean arterial pressure (MAP) and pulse pressure (PP) in early assessment on vascular crisis after wrist replantation. Methods〓A retrospective clinical data were analyzed in 8 cases from August 2014 to November 2015, who suffered from vessel crisis after wrist replantation (observation group), and 10 cases with stable vital signs in ICU as control group. Both groups received continuous brachial arterial pressure. MAP and PP were recorded at 2 h, 1 h, and 0.5 h before vessel crisis happened. All cases with vascular crisis were confirmed by digital subtraction angiography (DSA). Results〓All 8 cases with vessel crisis were handled in time and performed extremities survived after surgery. The values of MAP and PP (mmHg) recorded at 2 h,1 h,0.5 h were 70.13±4.86 and 46.88±4.84,62.00±4.48 and 51.88±4.27,66.25±1.51 and 66.13±1.16, respectively. The values of MAP and PP (mmHg) in control group were 72.5±3.3,46.4±2.8. However, only the value of PP at 0.5 h showed the significant statistical significance. Conclusion〓PP may be as an early predictor of vascular crisis after wrist replantation. However, the samples in this study was limited, as well as the measuring method of MAP and the design, which should be improved.

Key words: Wrist Replantation, Digital subtraction angiography, Mean arterial pressure, Pulse pressure

摘要： 【摘要】 目的 探讨平均动脉压及脉压差在断腕再植术后血管危象早期评估中的作用。方法〓回顾分析2014年8月~2015年11月,我院因腕部离断而接受断腕再植术后发生血管危象的8例患者,以ICU生命体征稳定的10例患者作为对照,进行持续直接肱动脉测压,记录发生血管危象前2 h、1 h、0.5 h的平均动脉压及脉压差。所有患者发生血管危象的诊断均经DSA证实。结果〓8例患者发生的血管危象均得到及时处理,术后全部成活。记录的2 h、1 h、0.5 h的平均动脉压及脉压差(mmHg)分别为70.13±4.86、46.88±4.84;62.00±4.48、51.88±4.27;66.25±1.51、66.13±1.16。对照组的平均动脉压及脉压差分别为72.5±3.3、46.4±2.8,仅在0.5 h记录的脉压差有显著的统计学意义。结论〓脉压差可能作为断腕再植术后早期血管危象发生的预测因子,但本研究样本量存在客观不足,而且在设计方案及测定方法上需要作进一步改进。

关键词: 断腕再植, 数字血管减影, 平均动脉压, 脉压差