改良红外热成像技术辅助设计腓动脉穿支螺旋桨皮瓣的临床应用  

Clinical application of modified infrared thermal imaging assisted design of peroneal artery perforator propeller flap

作　　者：周贤挺 潘佳栋[1] 邵国庆[2] 肖栋超 黄耀鹏[1] 尹善青[1] 范学锴[1] 王欣[1] ZHOU Xianting;PAN Jiadong;SHAO Guoqing;XIAO Dongchao;HUANG Yaopeng;YIN Shanqing;FAN Xuekai;WANG Xin(Department of Hand Surgery,Ningbo Sixth Hospital,Ningbo,Zhejiang Province 315000,China;Doppler Ultrasonic Department,Ningbo Sixth Hospital,Ningbo,Zhejiang Province 315000,China)

机构地区：[1]宁波市第六医院手外科,浙江宁波315000 [2]宁波市第六医院超声科,浙江宁波315000

出　　处：《中华显微外科杂志》2022年第3期260-265,共6页Chinese Journal of Microsurgery

基　　金：宁波市医学科技计划项目(2020Y53)。

摘　　要：目的探讨改良红外热成像技术辅助设计腓动脉穿支螺旋桨皮瓣的临床应用价值。方法 2019年3月至2021年5月,对14例拟行腓动脉穿支螺旋桨皮瓣患者,术中使用止血带控制下再灌注增强的红外热成像方法(TRATIM)定位穿支血管,计算敏感度、阳性预测值并记录检测时间。与彩色多普勒血流超声(CDU)定位穿支血管所需时间及敏感度、阳性预测值比较,P<0.05为差异有统计学意义。结果术后13例皮瓣完全成活,1例皮瓣远端表层坏死,经换药后愈合。12例供区仅留1条线形瘢痕,2例植皮愈合良好。术后随访6~13个月,皮瓣的色泽、质地与周围皮肤相近,未见明显臃肿。TRATIM和CDU定位腓动脉穿支血管的敏感度分别为88.0%和92.0%,阳性预测值为93.6%和95.8%,两者比较差异均无统计学意义(P>0.05)。定位穿支用时TRATIM为(3.71±0.80)min,CDU为(16.21±4.97)min,两者比较差异有统计学意义(P<0.01)。结论依靠止血带控制再灌注增强的TRATIM,术者能简单、快速、准确的定位腓动脉皮穿支血管,并可辅助设计更为精准的腓动脉穿支螺旋桨皮瓣。Objective To explore the clinical value of modified infrared thermal imaging assisted design of peroneal artery perforator propeller flap.Methods From March 2019 to May 2021,tourniquet-reperfusion augmented thermal imaging method(TRATIM)was used to locate the perforating vessels in 14 patients for surgery or peroneal artery perforator propeller flap.The sensitivity,positive predictive value and detection time were calculated and compared with the perforating vessels located by color Doppler ultrasound(CDU),P<0.05 is statistially significant.Results After operation,13 flaps survived completely,but 1 flap with distal surface necrosis and healed after dressing change.Only one linear scar was left in 12 cases,and 2 cases healed well by skin grafts.Followed-up for 6-13 months,and showed that the colour and texture of the flaps were similar to the surrounding skin,without obvious swelling.The sensitivity of TRATIM and CDU in location of peral perforator vessels were 88.0%and 92.0%,respectively,and the positive predictive value was 93.6%and 95.8%,with no statistical difference between TRATIM and CDU(P>0.05).The time of positioning perforator was(3.71±0.80)min for TRATIM and(16.21±4.97)min for CDU,There was significant difference between TRATIM and CDU(P<0.01).Conclusion With TRATIM,a surgeon can locate the peroneal perforator vessels simply,quickly and accurately,and help in design more accurate peroneal artery perforator propeller flap.

关 键 词：腓动脉穿支 螺旋桨皮瓣 热成像 彩色多普勒超声 显微外科技术 

分 类 号：R658.2[医药卫生—外科学]