摘要
目的应用激光多普勒监测游离股前外侧皮瓣血流灌注情况,探索游离股前外侧皮瓣术后血流灌注规律,并研究其在游离股前外侧皮瓣坏死预测中的可行性。方法分析2018年1月-2019年12月采用游离股前外侧皮瓣移植修复手部创面患者资料56例,术后均采用激光多普勒监测法监测皮瓣血流灌注情况。激光多普勒监测指标为术中供区皮瓣切取前、术后即刻、术后第1天、3天、5天、7天、9天的皮瓣血液灌注。结果术后第9天,56例皮瓣全部成活,其中2例在术后4 h发生动脉危象,探查后危象解除;8例发生静脉危象,处理后危象解除,皮瓣顺利成活。与皮瓣断蒂前相比,术后即刻及术后1~5 d血液灌注明显加快(P<0.01),血液灌注在术后第5天达到高峰,随后呈现下降趋势。结论激光多普勒能较早发现游离皮瓣血管危象,临床医生可更加了解皮瓣情况。游离皮瓣灌注总体呈现先上升后下降的趋势,为临床用药及护理工作提供参考依据。
Objective To monitor the perfusion of the anterolateral thigh flap by the laser astigmatism monitoring video system.To explore the feasibility of the anterolateral thigh flap necrosis,blood flow perfusion after flap operation.Methods From January 2018 to December 2019,we collected 56 cases of hand wounds with free anterolateral thigh flap transplantation,laser Doppler monitoring was used to monitor flap perfusion.The laser Doppler monitoring index was the perfusion of the flap before,immediately and on the 1st,3rd,5th,7th,and 9th day after operation.Results On the 9th day after surgery,all 56 flaps survived.Two of them had an arterial crisis 4 hours after surgery.After the exploration,the crisis was relieved.Eight patients were in the venous crisis.After the treatment,the crisis was relieved and the flap survived smoothly.We found that blood perfusion was significantly accelerated immediately after surgery and 1 to 5 days after surgery(P<0.01).Blood perfusion reached a peak on the 5th day after surgery,and then showed a downward trend.Conclusion Laser Doppler can detect the vascular crisis of free flaps earlier,and clinicians can understand the flaps more.The free flap perfusion shows a trend of increasing firstly and then decreasing,providing a reference for clinical medication and nursing work.
作者
李雪栋
陶明振
朱鹏飞
郑世军
LI Xuedong;TAO Mingzhen;ZHU Pengfei(Trauma Orthopedics,Zhengzhou Orthopedic Hospital,Zhengzhou,Henan,450052,China)
出处
《实用手外科杂志》
2024年第1期61-65,共5页
Journal of Practical Hand Surgery
关键词
血液灌注监测
游离股前外侧皮瓣
激光多普勒
Blood perfusion monitoring
Free anterolateral thigh flap
Laser Doppler
