MEDLINE/PubMed Journal Browser Search

Pubmed for Handhelds

PUBMED FOR HANDHELDS

Search MEDLINE/PubMed

Title: [Assessment of the radial and ulnar arteries hemodynamic changes by ultrasound in patients with primary palmar hyperhidrosis after thoracic sympathetic block].
Author: Fei Y, Xu MM, Huang B, Xie KY, Ni HD, Zhang L, Zhang HP, Yao M.
Journal: Zhonghua Yi Xue Za Zhi; 2017 Jun 13; 97(22):1729-1733. PubMed ID: 28606283.
Abstract:
Objective: To evaluate the value of radial and ulnar arteries hemodynamic changes by ultrasound in patients with primary palmar hyperhidrosis after thoracic sympathetic block. Methods: This was a prospective study, from January 2016 to September 2016, 23 patients with primary palmar hyperhidrosis were admitted to the First Hospital of Jiaxing City, Zhejiang Province, 92 arteries of these patients who underwent thoracic sympathetic block were enrolled into this study. Diameters, peak systolic velocity (PSV), end diastolic velocity (EDV) and resistive index (RI) of the radial and ulnar arteries were examined one day before and after the operation by color Doppler ultrasound. Spectral waveforms of these arteries were observed, and palms temperature (T), oxygen saturation (SpO(2)), perfusion index (PI) were also measured. Diameters, PSV, EDV, RI, T, SpO(2) and PI of the patients with PH were compared before and after the surgery. The effect of operation was also evaluated. Results: Before surgery, diameters and EDV of the radial and ulnar arteries of the patients with PH were(2.12±0.36) mm, (1.50±0.32) mm, (4.90±1.84) cm/s, (4.71±1.65) cm/s, respectively, after surgery, the diameter of the RA, UA and EDV were (2.45±0.54) mm, (1.87±0.44) mm, (9.37±1.69) cm/s and (9.12±1.54) cm/s, which were significantly increased.Before surgery, RI of the RA and UA of the patients were (0.85±0.05), (0.97±0.07) , respectively, after surgery, RI of the RA and UA were (0.57±0.04), (0.64±0.09), respectively, which were significantly decreased after surgery. The difference was statistically significant (t=-5.23, -2.33, -19.80, -14.68, 3.31, 3.48, all P<0.01). Before surgery, PSV of the RA and UA of the patients were (46.38±15.12) cm/s, (45.60±14.88) cm/s , respectively, after surgery, PSV of the RA and UA were (46.93±16.02) cm/s, (46.19±15.30) cm/s , respectively. The difference was not statistically significant (t=-0.23, -1.39, all P>0.05). Before surgery, T, SpO(2) and PI of the patients were(29.7±1.04) ℃, (93.24±2.23) %, (1.11±0.13) % , respectively, after surgery, T, SpO(2) and PI of the patients were (35.09±1.21) ℃, (98.10±1.34) %, (4.77±1.22)% , respectively. The difference was statistically significant (t=-20.174, -1.140, -23.601, all P<0.05). The symptoms of hyperhidrosis of the patients were disappeared immediately after the surgery in both hands. All of the patients were cured within 3 months and there was no severe complications. Conclusion: Thoracic sympathetic block increase Diameters and EDV but decrease RI of the radial and ulnar arteries of the patients with PH and increase the palms temperature. Artery diameters, EDV, and RI measured by ultrasound can be used as parameters to evaluate the effect of thoracic sympathetic block in patients with PH. It's objective, non-invasive and convenient. 目的： 应用超声评估原发性手汗症(PH)患者在胸交感神经阻滞术后桡动脉(RA)、尺动脉(UA)血流动力学变化。 方法： 本研究为前瞻性研究，选择2016年1至9月浙江省嘉兴市第一医院收治的行胸交感神经阻滞术的23例原发性手汗症患者92支上肢动脉。采用彩色多普勒超声于术前1 d、术后1 d检测RA、UA的内径、收缩期峰值流速(PSV)、舒张期末流速(EDV)、阻力指数(RI)，并观察频谱形态，同时测量PH患者双手掌温(T)、脉搏氧饱和度(SpO(2))及末梢灌注指数(PI)。比较PH患者手术前后RA、UA的内径以及PSV、EDV、RI、T、SpO(2)、PI的差异，评估手术效果。 结果： PH患者术前RA、UA内径及EDV分别为(2.12±0.36)mm、(1.50±0.32)mm、(4.90±1.84)cm/s、(4.71±1.65)cm/s，术后RA、UA内径及EDV分别为(2.45±0.54) mm、(1.87±0.44)mm、(9.37±1.69)cm/s、(9.12±1.54)cm/s，较术前增加；术前RA、UA的RI分别为0.85±0.05、0.97±0.07，术后分别为0.57±0.04、0.64±0.09，较术前减小，差异均有统计学意义(t＝－5.23、－2.33、－19.80、－14.68、3.31、3.48，均P<0.01)。术前RA、UA的PSV分别为(46.38±15.12)、(45.60±14.88)cm/s，术后分别为(46.93±16.02)、(46.19±15.30)cm/s，差异无统计学意义(t＝－0.23、－1.39，均P>0.05)。PH患者术前T、SpO(2)及PI分别为(29.79±1.04)℃、(93.24±2.23)%、(1.11±0.13)%，术后T、SpO(2)及PI分别为(35.09±1.21)℃、(98.10±1.34)%、(4.77±1.22)%，差异均有统计学意义(t＝－20.174、－1.140、－23.601，均P<0.05)。术后即刻患者双手多汗症状完全消失，所有PH患者疗效均能持续3个月以上，无严重并发症发生。 结论： 胸交感神经阻滞术能使PH患者RA、UA的内径增加，EDV增快，RI降低，双手掌温升高。超声测量动脉内径、EDV及RI可作为评价PH患者胸交感神经阻滞术后疗效的指标，且客观、无创、方便。.

[Abstract] [Full Text] [Related] [New Search]