红外热成像技术与彩色多普勒超声在股前外侧穿支皮瓣术前穿支血管探测中的比较  

Comparative study of infrared thermal imaging technology and colour Doppler ultrasound in the detection of perforator vessels before anterolateral femoral perforator flap

作　　者：徐宏征[1] 张书诺 章一新[2] 肖文天 闵沛如 XU Hongzheng;ZHANG Shunuo;ZHANG Yixin;XIAO Wentian;MIN Peiru(Department of General Surgery,Beijing ChuiYangLiu Hospital,Beijing 200011,China;Department of Plastic and Reconstructive Surgery,Shanghai Ninth People's Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200011,China)

机构地区：[1]北京市垂杨柳医院普通外科,北京100022 [2]上海交通大学医学院附属第九人民医院整形和重建外科,上海200011

出　　处：《中华显微外科杂志》2021年第4期388-391,共4页Chinese Journal of Microsurgery

基　　金：国家自然科学基金(81801918)。

摘　　要：目的探讨及对比红外热成像技术(IRT)与彩色多普勒超声(CDU)在股前外侧穿支皮瓣(ALTPF)术前穿支血管探测中的应用效果。方法自2017年9月至2019年9月,接受ALTPF手术行修复重建的患者共25例,其中男16例,女9例;年龄12~53岁,平均38.7岁;所有患者均切取带蒂或者游离的ALTPF,大小5.0 cm×8.0 cm~7.5 cm×30.0 cm,其中游离皮瓣21例,局部带蒂转移皮瓣4例。所有患者术前均常规行IRT以及CDU检查进行供区穿支血管定位。使用卡方检验比较术前探测与术中实际情况,统计一致性。结果本组25例中,术前CDU共检测出53条穿支血管,IRT共检测到51个"热点",其中50个"热点"与CDU的结果相对应,κ指数为0.712(P<0.05),代表高度一致性,敏感性为94.3%,特异性为85.7%,两者之间定位的偏移与皮下组织厚度呈正相关。结论利用IRT在ALTPF术前探测穿支血管与CDU相比具有高度的一致性,兼具便携、经济、无创、操作简便的特点,同时在皮下组织较薄的人群中具有更高的精准度,是术前穿支血管导航的重要组成部分。Objective To compare the reliability between infrared thermal imaging technology(IRT)and colour Doppler ultrasound(CDU)in the detection of perforators for anterolateral femoral perforator flap(ALTPF).Methods From September,2017 to September,2019,a total of 25 patients(16 males and 9 females,aged 12-53 years old with an average age of 38.7 years old)underwent ALTPF surgery for the purpose of resurfacing and reconstruction.All patients had pedicled or free ALTPF sized from 5.0 cm×8.0 cm to 7.5 cm×30.0 cm.Among all cases,21 received free flaps and 4 received pedicled flaps.All patients underwent routine IRT and CDU examinations to locate the perforators preoperatively.Results Of the 25 patients,CDU detected 53 perforators and IRT detected 51"hot spots".There were 50"hot spots"that corresponded to the findings of CDU with a K index at 0.712(P<0.05),representing a high degree of consistency.The sensitivity and specificity were 94.3%and 85.7%,respectively.Conclusion IRT has a high consistency in detecting perforators for ALTPF in comparison with CDU.IRT features portable,low cost,non-invasive,and easy to operate.At the same time,IRT has advantages in the patients who have thin subcutaneous tissue.With higher accuracy,IRT is expected to become an important part of preoperative perforator navigation.

关 键 词：股前外侧穿支皮瓣 红外热成像技术 穿支血管探测 彩色多普勒超声 

分 类 号：R622[医药卫生—整形外科]