Experimental Study on Peripheral Hemodynamics in Chronic Peripheral Arterial Occlusive Diseases in Reference to Non Surgical

为了阐明慢性外周动脉闭塞症(肢体缺血)患者步行锻炼后血流动力学的改善，对外科手术诱发的肢体缺血后肢体组织血流灌注的改善进行了实验评估。在具有医学质谱仪的在线计算机系统的辅助下，根据模拟缺血腿运动的电刺激后组织PCO2的清除曲线，计算局部组织灌注率。术后1个月、3个月、6个月、12个月局部组织灌注率分别由9.51、14.59、15.11、17.19(对照组为17.75)增加到12.41、14.59、15.11、17.19(对照组为17.75)。局部组织灌注率随着PGE1的应用而增加，1个月时为14.11，3个月时为16.48，6个月时为19.13。持续运动和/或应用PGE1可改善缺血症状，这归因于组织灌注量或侧支循环的改善。根据慢性周围动脉闭塞症的自然病史，特别是间歇性跛行，非手术治疗是可行的。

Improvements in limb tissue perfusion following surgically induced ischemia in dogs were experimentally evaluated to clarify the improvement in hemodynamics following walking exercise in chronic, peripheral arterial occlusive diseases (ischemic limbs). Assisted by an on-line computer system with medical mass spectrometry, local tissue perfusion rate was calculated on the basis of the clearance curve of tissue pCO_2 following electrical stimuli that simulated exercise in the ischemic legs. Local tissue perfusion rate improved in ml/100g/min from 9.51 to 12.41 in one month, 14.59 in three months, 15.11 in six months and 17.19 at twelve months (17.75 in control group).No significant increase in the perfusion rate was found between the groups with and without lumbar sympathetic ganglionectomy. Local tissue perfusion rate was found increased with the application of PGE_1 ; 14.11 at one month, 16.48 at 3 months and 19.13 at 6 months.The improvement of ischemic symptoms with continued exercise and/or with PGE_1 is attributed to improvements in tissue perfusion or in collateral circulation, non surgical treatments based on the natural history of chronic peripheral arterial occlusive disease, particularly intermittent claudication, appear feasible.