Realtime evaluation of the tracheal blood flow with use of laser doppler flowmeter during operation for the esoghageal cancer wit radical lymph nodes dissection

食管癌淋巴结清扫术中激光多普勒流量计实时评估气管血流

• 批准号: 06671242
• 负责人: KOIDE Yoshio
• 金额: $ 1.02万
• 依托单位: Chiba University
• 依托单位国家: 日本
• 项目类别: Grant-in-Aid for General Scientific Research (C)
• 财政年份: 1994
• 资助国家: 日本
• 起止时间: 1994 至 1995
• 项目状态: 已结题
• 来源: https://kaken.nii.ac.jp/en/grant/KAKENHI-PROJECT-06671242/
• 关键词: esophageal cancer; radical lymph nodes dissecton of the upper mediastinum; tracheal blood flow; bronchial arteries; laser doppler flowmeter; preserve the blood supply; リンパ節徹底郭清; 気管・気管支

It is important to preserve the blood supply to the trachea during the operation for the esophageal cancer with radical lymph nodes dissecton of the upper mediastinum. In this study, the change of the tracheal blood flow (TBF) was measured with use of laser doppler flowmeter (LDF) during the operation. Materials and Methods ; The change of TBF of 21 patients was measured with LDF during the general surgery and that of three dogs was measured during the radical lymph nodes dissection of the upper mediastinum with ligature of the bronchial arteries. The sensor of the LDF was fixed to the endotracheal cuff and attached to the tracheal mucosa of the membranous wall. Results ; TBF which measured with LDF decreased when the tracheal cuff pressure rose and increased when it fell. LDF made rapid responce to the change of TBF.During the arteficial respiration, TBF increased by expiration and decreased by inspiration. TBF increased when blood pressure rose rapidly and decreased when it fell. TBF increased by raising of the legs and the arms, by using of pneumatic tourniquet and by the pneumoperitoneum. It decreased by static oppression of the trachea at the neck. During the dissection of the upper mediastinum of the dogs, TBF decreased after the ligature of the intercostobronchial arteries and the bronchial arteries arising from the aorta. After the resection of the tracheal proper seaths, TBF did not changed. Disscusion ; LDF could measure the rapid change of TBF and had the possibility to be useful as the anesthetic monitor system. We reported the anatomy of the bronchial arteries before this study and described that they course through the tracheal proper sheath to the trachea. The present study support it from the view of the blood flow, and preserving the bronchial arteries and the tracheal proper sheath is important during the upper medaistinum dissection.

重要的是要在上纵隔的根部淋巴结剖析食管癌的手术过程中保留气管的血液供应。在这项研究中，操作过程中使用激光多普勒流量计（LDF）测量气管血流（TBF）的变化。材料和方法；在一般手术期间，用LDF测量了21例患者的TBF的变化，并在上纵隔的自由基淋巴结解剖过程中测量了三只狗的变化。 LDF的传感器固定在气管袖口上，并附着在膜壁的气管粘膜上。结果 ;当气管袖口压升时，用LDF测量的TBF降低并降落时增加。 LDF对TBF的变化进行了快速呼应。在骨管呼吸的情况下，TBF通过到期而增加，并随着灵感而减少。当血压迅速上升并降低时，TBF升高。 TBF通过使用气动止血带和气动性通过使用腿和手臂来增加。它因颈部气管的静态压迫而降低。在狗的上纵隔解剖过程中，TBF在阶层间动脉和主动脉引起的支气管动脉的绑扎后减少。切除气管适当的壁画后，TBF没有改变。失调； LDF可以衡量TBF的快速变化，并有可能作为麻醉监测器系统有用。我们在这项研究之前报道了支气管动脉的解剖结构，并描述它们通过气管适当的鞘穿过气管。本研究从血流的视图中支持了它，并保留支气管动脉和气管适当的鞘在上医生解剖过程中很重要。