激光散斑血流成像在预测烧伤患者创面愈合时间中的应用  

Application of laser speckle perfusion imaging in predicting wound healing time of burn patients

作　　者：蒋梅君[1] 褚志刚[2] 谢琼慧[2] 黄文卫[2] 阮晶晶[2] 谢卫国[2] 

机构地区：[1]武汉大学中南医院普外科,430071 [2]武汉大学同仁医院暨武汉市第三医院烧伤科

出　　处：《中华烧伤杂志》2016年第12期721-724,共4页Chinese Journal of Burns

基　　金：国家自然科学基金青年科学基金（81501667）;武汉市科学技术计划（2013061402010510、2015070404010214）;武汉市卫计委临床医学科研项目（WX14814、WX13A08）

摘　　要：目的探讨激光散斑血流成像技术在预测烧伤患者创面愈合时间中的应用效果。方法对2014年5—12月在武汉大学同仁医院暨武汉市第三医院烧伤科住院的84例成年烧伤患者，在伤后24～72h进行激光散斑血流成像检测创面血流值，并记录创面愈合时间。根据愈合时间将128个创面分为浅度组（小于或等于14d愈合）57个和深度组（大于14d且小于或等于28d愈合）71个。比较2组创面的血流值。对数据行t检验、x2检验。绘制受试者工作特征曲线结合约登指数得出2组创面愈合时间的最佳临界血流值，经Kappa一致性检验分析，评估该临界值的有效性。结果（1）浅度组创面的血流值为（6．8±1．8）灌注单位（PU），明显高于深度组的（3．5±1．3）PU（t=11．404，P〈0．01）。（2）预测创面愈合时间的血流值受试者工作特征曲线下面积为0.931（95％置信区间为0．887～0．975，P〈0．01），结合约登指数，2组创面愈合时间的最佳临界血流值为5．52Pu，其敏感度为76．9％、特异度为94．7％。（3）经预测，愈合时间小于或等于14d的有44个创面、大于14d且小于或等于28d的有84个创面，实际愈合小于或等于14d的有57个创面，大于14d且小于或等于28d的有71个创面，二者一致性检验的Kappa系数为0．754（P〈0．01）。结论激光散斑血流成像技术可较好地预测烧伤创面愈合时间。Objective To explore the application effect of laser speckle perfusion imaging （LSPI） in predicting wound healing time of burn patients. Methods LSPI was performed in 84 adult burn patients hospitalized in department of burns of Tongren Hospital of Wuhan University ＆ Wuhan Third Hospital within post injury hour （PIH） 24 to 72 to detect the blood perfusion values of the wounds. The wound healing time was recorded. The 128 wounds were divided into superficial group （wound healing time shorter than or equal to 14 d, n =57） and deep group （wound healing time longer than 14 d and shorter than or equal to 28 d, n = 71 ） according to the healing time. The blood perfusion values of the two groups were compared. Data were processed with t test or chi-square test. The receiver operating characteristic （ROC） curve was drawn and Youden index was calculated to determine the optimal critical blood perfusion value of wound healing time of the two groups, and the validity of the critical value was assessed by Kappa consistency test. Results （1） The blood perfusion value of woundsin superficial group was （6.8 ± 1.8） perfusion unit （PU）, which was significantly higher than （3.5±1.3） PU in deep group （ t =11.404, P 〈0.01）. （2） The total area under ROC curve of blood perfusion value to predict wound healing time was 0. 931 （with 95% confidence interval 0. 887 - 0. 975, P 〈 0. 01 ）. Combined with Youden index, 5.52 PU was chosen as the optimal critical value of wound healing time of the two groups, with sensitivity of 76.9% and specificity of 94.7%. （3） The healing time of 44 wounds predicted was shorter than or equal to 14 d, and the healing time of 84 wounds predicted was longer than 14 d and shorter than or equal to 28 d, while the actual number of wounds was 57 and 71, respectively. The Kappa coefficient of consistency test was 0. 754 （ P 〈0.01 ）. Conclusion LSPI is a useful method to predict the healing time of burn wounds.

关 键 词：烧伤 伤口愈合 局部血流 激光散斑血流成像 

分 类 号：R644[医药卫生—外科学]