组织工程与重建外科杂志

组织工程与重建外科杂志 ›› 2018, Vol. 14 ›› Issue (3): 139-142.doi: 10.3969/j.issn.1673-0364.2018.03.006

• 论著 • 上一篇    下一篇

吲哚菁绿荧光造影在穿支皮瓣微循环检测中的应用

喜雯婧，李科，冯少清，章一新   

  1. 上海交通大学医学院附属第九人民医院整复外科
  • 收稿日期:2018-04-07 发布日期:2020-07-23
  • 作者简介:章一新（E-mail：zhangyixin6688@163．com）。

The Application of the Indocyanine Green Angiography in the Micro-Circulation Evaluation of Perforator Flaps

XI Wenjing,LI Ke,FENG Shaoqing,ZHANG Yixin   

  1. Department of Plastic and Reconstructive Surgery, Shanghai Ninth People’s Hospital, Shanghai Jiaotong University School of Medicine
  • Received:2018-04-07 Published:2020-07-23
  • Contact: 上海市科委优秀技术带头人计划(18XD1423700)；国家自然科学基金面上项目(81772098)；上海交通大学医学院附属第九人民医院临床研究型多学科诊疗团队建设项目(2017-1-007)；上海交通大学医学院附属第九人民医院临床研究助推计划(JYLJ027)；上海市教委高峰高原计划—“研究型医师”项目(20152227)

摘要： 目的评价吲哚菁绿荧光造影在皮瓣微循环检测中的准确性和安全性。方法回顾2014年7月至2018年5月的15例皮瓣手术,术中对皮瓣进行吲哚菁绿荧光造影,将术中造影结果与术中传统主观评估结果进行比较;术后2周记录皮瓣成活情况,将之与术中造影结果进行比较,并记录并发症情况。结果 15例皮瓣造影发现7例皮瓣存在微循环问题,传统主观观察法仅发现2例存在微循环障碍。其中,3例皮瓣在处理后再次造影仍提示有局部循环障碍,术后这3例皮瓣均发生局部坏死,坏死区域与术中造影"暗区"基本相符。所有术中造影患者术后均未出现相关并发症。结论吲哚菁绿荧光造影检测皮瓣灌注情况的准确性高,对皮瓣微循环障碍的敏感性高,可有效降低皮瓣术后局部坏死发生率,在临床应用中具有一定的实用价值。

关键词: 吲哚菁绿, 穿支皮瓣, 微循环

Abstract: Objective To evaluate the accuracy and safety of indocyanine green angiography in the micro-circulation evaluation of perforator flaps.Methods Indocyanine green(ICG)angiography was carried out in 15 perforator-flap surgeries from July 2014 to May 2018.The evaluation results by traditional methods were compared with the angiography.The final survival of the flaps was compared with the intra-operative angiography results 2 weeks after surgery.Complications were noted.Results ICG angiography detected that 7 flaps had microvascular problems while only 2 cases were discovered by traditional methods.In 3 cases the microcirculation problem could not be corrected during the surgery.Partial necrosis took place in all 3 cases and the necrosis area matched the non-perfusion area in the intra-operative ICG angiography.Conclusion ICG angiography is accurate in perfusion evaluation of the perforator flaps.It is more sensitive to the microcirculation problems than traditional evaluation methods.It can effectively reduce the incidence of partial necrosis.ICG angiography has practical value in perforator flaps surgeries.

Key words: Indocyanine green, Perforator flaps, Micro-circulation

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