ПЕРИАРТЕРИАЛЬНАЯ ДИГИТАЛЬНАЯ СИМПАТЭКТОМИЯ В ЛЕЧЕНИИ ФЕНОМЕНА РЕЙНО

Abstract

Objective: To analyze the results of the first experience of performing periarterial digital sympathectomy in Raynaud’s phenomenon. Methods: The results of periarterial digital sympathectomy were studied in 10 patients with the Raynaud’s phenomenon. All patients were females aged 22 to 28 years. Diagnosis of the pathology was based both on the clinical manifestations of the Raynaud’s phenomenon, and on the results of stress tests and instrumental research methods (duplex scan, rheovasography, and percutaneous oxygen tension). All patients underwent a one-sided periarterial sympathectomy of the fingers, 4 on the left and 6 on the right. In the perioperative period were determined the rate of blood flow through the palmar digital arteries, rheographic index and oxygen saturation in the tissues. Results: In all cases, the presence of chronic ischemia of the hand, manifested by periodic vasospasm and vasoconstriction, cyanotic fingers and a decrease in their sensitivity was revealed. According to the data of duplex scan, there was a decrease in the linear velocity of blood flow (9.7±1.8 cm/s in the digital arteries, 10.4±2.1 cm/s in the palmar arch), the tension of oxygen in the fingers (58.5±7.5) and brushes (65.5±9.5) and a decrease in the rheographic index (0.4±0.3). In all cases, periarterial sympathectomy was performed according to Leriche’s method. In the perioperative period, there were no complications. The duration of the operation was 85.5±10.5 minutes, hospitalization 5.5±0.5 days. In the immediate postoperative period, a good hemodynamic effect was observed in the form of leveling the clinical signs of the disease, increasing the linear velocity of blood flow both in the digital arteries (up to 15.8±2.1 cm/s) and in the palmar arch (21.2±2,5 cm/s) with improved perfusion of the tissues of the hand and fingers and an increase in the rheographic index to 0.75±0.5. Conclusion: Periarterial digital sympathectomy effectively reduces ischemia of the hand and fingers in the Raynaud’s phenomenon Keywords: Raynaud’s phenomenon, sympathectomy, ischemia, results.