吲哚菁绿荧光成像技术在腹腔镜下肠隔膜手术中的应用研究  

Application of indocyanine green fluorescent imaging for laparoscopy of intestinal diaphragm

作　　者：季春宜[1] 尹强[1] 袁妙贤[1] 陈立健[1] 谢惟心 彭宇明 Ji Chunyi;Yin Qiang;Yuan Miaoxian;Chen Lijian;Xie Weixin;Peng Yuming(Department I of General Surgery,Hunan Children's Hospital,Changsha 410007,China)

机构地区：[1]湖南省儿童医院普外一科,湖南省长沙市410007

出　　处：《临床小儿外科杂志》2021年第10期911-915,共5页Journal of Clinical Pediatric Surgery

基　　金：湖南省卫健委重点专科建设技术创新项目(编号:湘卫医政医管处函[2018]187号)。

摘　　要：目的探讨吲哚菁绿(indocyanine green,ICG)分子荧光成像技术在先天消化道畸形肠隔膜手术中的应用价值。方法以2018年5月至2020年12月湖南省儿童医院普外一科10例肠隔膜患者作为研究对象,所有患者在ICG分子荧光成像技术指导下完成手术。术中按0.5 mg/kg剂量、将2.5 mg/20 mL ICG稀释液经胃管注入,通过ICG分子荧光成像技术对肠隔膜进行实时定位引导;术中完成吻合后再对吻合口部进行ICG分子荧光检测,协助判断有无渗漏。结果10例患者均在ICG分子荧光成像技术辅助下,术中实时呈现肠隔膜的精准定位,且发现肠吻合口渗漏1例,予以及时修补后再次检测原肠吻合口渗漏处无荧光聚集;术后无一例肠漏发生。结论ICG分子荧光成像技术不仅可在术中实时精准定位肠隔膜,而且发现吻合口渗漏的敏感度高。ICG分子荧光成像技术在儿童先天消化道畸形的手术导航中具有一定的临床应用价值。Objective To explore the value of application of precise surgical navigation of indocyanine green(ICG)fluorescent imaging for improving the safety and effectiveness of surgery for congenital gastrointestinal malformation of intestinal diaphragm.Methods From May 2018 to December 2020,ICG molecular fluorescent imaging was applied for 10 patients with intestinal diaphragm disease.Intraoperative transgastric tube dosing was adpoted.After injecting ICG into a gastric tube with 2.5 mg/20 mL ICG diluent at a dose of 0.5 mg/kg,ICG molecular fluorescent imaging was performed for real-time positioning and guidance of intestinal diaphragm.Upon a completion of anastomosis,ICG molecular fluorescent detection was performed on the anastomosis for assisting in detecting possible leakages.Results With an aid of ICG molecular fluorescent imaging,intestinal diaphragms were precisely positioned during real-time operations.One intestinal anastomotic leakage was detected during operation.After repairing in time,original intestinal anastomotic leakage was plugged without fluorescent accumulation and no intestinal leakage occurred postoperatively.Conclusion ICG molecular fluorescent imaging may locate intestinal diaphragm in a real-time operation and detect anastomotic leakage with a high sensitivity.This technology has a certain practical value of surgical navigation for children with congenital gastrointestinal malformations as it enhances the safety and effectiveness of operations.

关 键 词：荧光染料 吲哚菁绿 诊断显像 腹腔镜检查 肠隔膜 儿童 

分 类 号：R917.76[医药卫生—药物分析学] R726.556[医药卫生—药学]