吲哚箐绿荧光显影在股前外侧皮瓣术中穿支示踪、选择的可行性及效果评价

doi:10.19438/j.cjoms.2022.04.014

中国口腔颌面外科杂志 ›› 2022, Vol. 20 ›› Issue (4): 396-400.doi: 10.19438/j.cjoms.2022.04.014

吲哚箐绿荧光显影在股前外侧皮瓣术中穿支示踪、选择的可行性及效果评价

陈一铭, Ahmed, 季彤^*, 任振虎^*

上海交通大学医学院附属第九人民医院口腔颌面-头颈肿瘤科,上海交通大学口腔医学院, 国家口腔医学中心,国家口腔疾病临床医学研究中心,上海市口腔医学重点实验室,上海 200011

收稿日期:2022-05-08 修回日期:2022-05-30 出版日期:2022-07-20 发布日期:2022-07-20
通讯作者: 任振虎,E-mail：zhenhuren@126.com;季彤,E-mail：jitongjitong@foxmail.com。^*共同通信作者
作者简介:陈一铭（1989-）,男,博士,主治医师,E-mail: 781368531@qq.com

Intra-operative vascular mapping with indocyanine green: a real time guide for perforator selection of anterolateral thigh flap

CHEN Yi-ming, Ahemd, JI Tong, REN Zhen-hu

Department of Oromaxillofacial 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 200011, China

Received:2022-05-08 Revised:2022-05-30 Online:2022-07-20 Published:2022-07-20

摘要/Abstract

摘要： 目的: 探讨吲哚箐绿荧光显影在股前外侧皮瓣术中穿支示踪、选择的可行性以及效果。方法: 选取2020年9月—2021年12月于上海交通大学医学院附属第九人民医院接受股前外侧皮瓣修复的头颈部肿瘤患者,术中暴露股直肌与股外侧肌间隙以及穿支进皮位点后,注射吲哚箐绿。使用荧光探测器记录旋股外侧动脉分支及每个穿支显影时间、信号强度,后续做手术解剖,验证穿支走行。采用SPSS 19.0软件包对数据进行统计学分析。结果: 纳入30例患者,其中,男16例,女14例;年龄36~70岁。不同患者穿支组成无显著差异。根据穿支显影时间分类,60个Ⅰ类,15个Ⅱ类,10个Ⅲ类,每个皮瓣平均有2条Ⅰ类穿支。吲哚箐绿穿支示踪正确率为97.6%。结论: 吲哚箐绿荧光显影可在术中提供股前外侧皮瓣穿支走行示踪,并对每条穿支的血流进行评估以选出最可靠穿支,从而降低手术风险,并减少手术时间。

关键词: 吲哚箐绿, 股前外侧皮瓣, 穿支, 血管示踪

Abstract: PURPOSE: To evaluate the value of intra-operative application of indocyanine green of mapping and selecting perforators of anterolateral thigh flap. METHODS: A prospective study was adapted for head neck tumor patients who underwent anterolateral thigh flap reconstruction from 2020.9 to 2020.12 in Shanghai Ninth People's Hospital. Indocyanine green was injected, when lateral femoral circumflex artery and perforator were found, fluorescence detector was used to evaluate the signal time and strength of perforator and branches of lateral circumflex femoral artery, as well as mapped the tract. Surgical anatomy was conducted to confirm the previous results. SPSS 19.0 software package was used for data analysis. RESULTS: Thirty patients were collected, 16 were males and 14 were females, aging from 36 to 70 years old. There was no significant difference for perforators distribution within patients. As perforator classification, classⅠ: 60, classⅡ:15, and class Ⅲ :10. Each flap had 2 classⅠperforator on average. The accuracy for perforator tract based on indocyanine green was 97.6%. CONCLUSIONS: Intra-operative application of indocyanine green is useful in mapping and selecting perforators of anterolateral thigh flap, which also reduced the surgical time and risk.

Key words: Indocyanine green, Anterolateral thigh flap, Perforator, Vascular mapping

中图分类号:

R782.2

陈一铭, Ahmed, 季彤, 任振虎. 吲哚箐绿荧光显影在股前外侧皮瓣术中穿支示踪、选择的可行性及效果评价[J]. 中国口腔颌面外科杂志, 2022, 20(4): 396-400.

CHEN Yi-ming, Ahemd, JI Tong, REN Zhen-hu. Intra-operative vascular mapping with indocyanine green: a real time guide for perforator selection of anterolateral thigh flap[J]. China J Oral Maxillofac Surg, 2022, 20(4): 396-400.

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吲哚箐绿荧光显影在股前外侧皮瓣术中穿支示踪、选择的可行性及效果评价

Intra-operative vascular mapping with indocyanine green: a real time guide for perforator selection of anterolateral thigh flap

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