微循环监测方法在皮瓣断蒂前的应用  

Microcirculation of lateral groin skin flaps:monitoring and clinical application

作　　者：杨欣[1] 马继光[1] 王佳琦[1] 孙广慈[1] 

机构地区：[1]中国医学科学院中国协和医科大学整形外科医院,北京100041

出　　处：《中华整形外科杂志》2002年第5期283-284,共2页Chinese Journal of Plastic Surgery

摘　　要：目的　监测腹股沟外侧皮瓣微循环血流动态变化及其规律 ,为选择最佳断蒂时间提供可靠客观量化指标。方法　应用激光多普勒血流计 (LDF)对 12例腹股沟外侧皮瓣移转面中点逐日进行微循环监测 ,皮瓣移植后第 4d起记录皮瓣蒂部阻断前、后LDF的灌注单位 (perfusionunits ,PU)值变化情况。结果　腹股沟外侧皮瓣微循环血流变化可分为两期 ,即术后前 6d的骤升期 ,PU值分别为 2 83± 0 4 6、3 2 1± 0 4 1、3 6 6± 0 4 3、4 77± 0 71、7 0 8± 0 37;术后 6～ 11d的平台期 ,PU值分别为 7.5 3± 0 .4 1、7.5 7± 0 .6 2、7.70± 0 .4 4、7.6 0± 0 .2 6、7.5 8± 0 .17。本组断蒂时间为术后 8～ 11d。结论　腹股沟外侧皮瓣移转用以修复手背及腕部缺损 ,其微循环血流变化在平台期稳定期时 ,在阻断皮瓣蒂部后其PU值恢复到或超过阻断前水平的 5 0 %时进行断蒂 ,皮瓣全部成活。Objective\ To monitor the microcirculation of lateral groin skin flaps. Methods\ The microcirculation in 12 lateral groin skin flaps was monitoried continuously by laser doppler flowmetry (LDF). Results\ The microcirculatory changes in lateral groin skin flaps were divided into two phases: rapid rising (2～6 days after operation) and plateau (6～11 days after operation). PU values were 2.83±0.46、3.21±0.41、3.66±0.43、4.77±0.71、7.08±0.37;7.53±0.41、7.57±0.62、7.70±0.44、7.60±0.26、7.58±0.17. Conclusion\ In clinical application, division of the lateral groin skin flaps within the plateau, and the values (PU) returned to or exceeded 50% of that values (PU) determined before application of the tourniquet, causes flaps survival (100%). The time of division was decreased to 8～11 postoperative days in our clinical application.\;

关 键 词：监测方法 断蒂 皮瓣 微循环 激光多普勒血流计 LDF 

分 类 号：R622.1[医药卫生—整形外科]