游离皮瓣监测技术  

Monitoring technology for free flap

作　　者：韩婧[1] 门宇航 刘剑楠[1] Han Jing;Men Yuhang;Liu Jiannan(Department of Oral and Maxillofacial Head and Neck Oncology,Shanghai Ninth People’s Hospital,Shanghai Jiao Tong University School of Medicine,College of Stomatology,Shanghai Jiao Tong University,National Center for Stomatology,National Clinical Research Center for Oral Diseases,Shanghai Key Laboratory of Stomatology,Shanghai Research Institute of Stomatology,Shanghai 200011,China)

机构地区：[1]上海交通大学医学院附属第九人民医院口腔颌面头颈部肿瘤科、上海交通大学口腔医学院国家口腔医学中心、国家口腔疾病临床研究中心、上海市口腔医学重点实验室、上海市口腔医学研究所,上海200011

出　　处：《中华整形外科杂志》2024年第12期1351-1356,共6页Chinese Journal of Plastic Surgery

基　　金：国家自然科学基金(82170923)。

摘　　要：游离皮瓣移植是整形外科常用的组织缺损修复方法。维持微循环和组织氧合作用是皮瓣手术成功的关键。皮瓣危象通常发生在术后72 h内, 发生率为5%~25%。皮瓣抢救成功率与危象发生到纠正的时间直接相关。因此, 早期发现危象是提高皮瓣抢救成功率的关键。传统皮瓣监测主要依赖临床观察, 如颜色、温度、肿胀、质地、毛细血管再充盈和针刺试验等。然而, 这些评估依赖于临床医生的经验, 具有很强的主观性。较为客观的皮瓣评估方法, 如置入式多普勒、彩色双功能超声、红外光谱监测、红外热成像、荧光造影和高光谱成像等技术也已被广泛研究和应用。该文对游离皮瓣监测的研究和临床应用进行了阐述。Free flap is commonly used for complex tissue defects in plastic surgery.Maintaining microvascular blood supply and tissue oxygenation are the keys for flap survival.Flap crisis usually occurs 72 hours after surgery and occurs in about 5%-25%of patients.The success rate of flap rescue is directly related to the time from crisis occurrence to correction.Therefore,early detection of crisis is the key to improve the success rate of skin flap rescue.Traditional flap monitoring relies mainly on clinical observations such as color,temperature,swelling,texture,capillary refill,and needling tests.However,these assessments are highly subjective and dependent on the experience of the clinician.Objective methods of skin flap evaluation such as implantable Doppler,color bifunctional ultrasound,infrared spectroscopy monitoring,infrared thermal imaging,fluorescence contrast and hyperspectral imaging have also been widely studied.The research progress and clinical application of monitoring technique of free flap were reviewed in this paper.

关 键 词：外科皮瓣 游离皮瓣 皮瓣监测 多普勒超声 红外热成像 高光谱成像 

分 类 号：R47[医药卫生—护理学]