吲哚菁绿红外显像联合亚甲蓝染色精确定位在下肢淋巴管-静脉吻合术中的应用  

Application of Indocyanine Green Lymphography Combined with Methylene Blue Staining for Accurate Position in Lymphaticovenular Anastomosis of Lower Limbs

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作  者:周煦川 苏学峰 马戈甲 王文飞 秦傲霜 刘宾 ZHOU Xuchuan;SU Xuefeng;MA Gejia;WANG Wenfei;QIN Aoshuang;LIU Bin(Department of Burn Plastic and Cosmetic Surgery,Xi'an Central Hospital,Xi'an Jiaotong University,Xi'an 710003,Shaanxi,China)

机构地区:[1]西安交通大学附属西安市中心医院烧伤整形美容外科,陕西西安710003

出  处:《中国美容医学》2024年第3期41-44,共4页Chinese Journal of Aesthetic Medicine

基  金:西安市创新能力强基计划-医学研究项目(编号:22YXYJ0077)。

摘  要:目的:通过吲哚菁绿红外显像联合亚甲蓝染色,进行下肢淋巴管-静脉吻合术(Lymphaticovenular anastomosis,LVA),分析改良定位方法的应用价值。方法:选取2020年10月-2022年5月笔者科室收治的40例下肢淋巴水肿的患者为研究对象,按随机数字表法分为对照组与研究组,每组20例。两组分别以吲哚菁绿(Indocyanine green,ICG)红外显像联合亚甲蓝染色(研究组)和单纯ICG红外显像(对照组)作为定位方法,行LVA治疗,比较术中吻合淋巴管数目、淋巴管寻找时间、淋巴管吻合时间等数据差异。采用下肢淋巴水肿指数(Lower extremity lymphedema index,LELI)作为预后指标,观察研究组和对照组术后半年淋巴水肿症状缓解情况。结果:研究组吻合淋巴管数目高于对照组,淋巴管寻找时间低于对照组(P<0.05);两组淋巴管吻合时间比较差异无统计学意义(P>0.05);LVA术后半年,两组LEL指数均小于术前(P<0.05)。结论:ICG红外显像联合亚甲蓝染色精确定位具有实时可视、定位精确等优点,可提高吻合淋巴管数目,缩短术中寻找淋巴管时间,预后良好,具有较高的临床应用价值。Objective To investigate the application of indocyanine green lymphography combined with methylene blue staining in lymphaticovenular anastomosis(LVA) of lower limbs,and analyze the advantages of the improved localization method.Methods Forty patients with lower limb lymphedema treated in the author's department from October 2020 to May 2022 were selected as the study objects, and were divided into control group and study group according to random number table method,with 20 cases in each group.The patients were treated with LVA using indocyanine green(ICG) lymphography combined with methylene blue staining and simple ICG lymphography as the positioning method,respectively.The number of lymphatic vessels anastomosed,the time of lymphatic vessel search,and the time of lymphatic vessel anastomosis were compared.Lower extremity lymphedema index(LELI) was used as the prognostic index,the symptom relief of lymphedema half a year after LVA was evaluated in both research group and control group. Results The number of anastomotic lymphatic vessels in the study group was higher than that in the control group(P<0.05),and the searching time of lymphatic vessels was lower than that in the control group;There was no significant difference in lymphatic anastomosis time between the two groups(P>0.05).The LEL index of the research group and the control group half a year after LVA were lower than that before operation(P<0.05).Conclusion ICG Indocyanine combined with methylene blue staining has the advantages of real-time visualization and accurate localization,which can increase the number of anastomotic lymphatic vessels,shorten the time of searching lymphatic vessels during operation.It has a good prognosis and high clinical application value.

关 键 词:下肢淋巴水肿 淋巴管-静脉吻合术 超显微外科 吲哚菁绿 亚甲蓝 定位 

分 类 号:R616.2[医药卫生—外科学]

 

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