【作者】 尹健； 孟扬； 张学慧； 丁海曙； 李岳； 肖春花； 宁连胜； 张天浩；

【Author】 Yin Jian Meng Yang Zhang Xue-Hui et al. Department of Breast, Cancer Hospital, Tianjin Medical University

【机构】 天津医科大学附属肿瘤医院乳腺科； 南开大学物理学院光子学中心； 清华大学医学院生物医学工程系；

【摘要】 目的:明确横行腹直肌肌皮瓣乳房再造(TRAM) 围术期皮瓣血氧变化规律及其在临床应用中的指导意义。方法:在围术期利用近红外血氧分析仪对TRAM乳房再造患者皮瓣各区的血氧状况进行检测,将其与临床观察结果进行对比。结果:TRAM皮瓣血氧状况存在规律性。通常,术中组织血氧指数(TOI)最低,术后4h左右,开始大幅上升,并持续8—9h的高峰,术后12-14h回落至术前水平。 16例皮瓣全部成活。其中1例II区皮肤轻微淤血,而TOI 未见异常。结论:术后14h内是TRAM皮瓣重建血运的关键阶段,应予密切观察。利用近红外血氧分析仪可以达到对 TRAM皮瓣血氧状况的快速、无创、便携、连续、实时监测,可以更真实地反映皮瓣深部的血氧状况,为准确判断皮瓣成活情况提供依据。更多还原

【Abstract】 Objective: Assessment of perioperative tissue oxygen condition of breast reconstruction with TRAM flaps by using NIRS. Methods: With help of NIRS, we proceed long time inspection in each sites of flaps, and compare results with clinical observations. Results: Oxygen conditions of TRAM flaps changed regularly. During the operation, TOI reached the lowest point. About 4 hours postoperation, TOI began to raise and persisted acme for 8-9h, TOI went back to normal in the 12-14h. All of the flaps survived. One of the flaps had minor ecchymosis in site II, however, TOI still normal. Conclusion: We suggest TRAM flaps inspection within 14 hours should be considerable because it is time that TRAM flaps reconfigured their vessel. NIRS has advantages in fast, non-invasive, convenience, continuous,real time inspection, besides, we can get oxygen conditions in deep flaps after transplanted and judge the survival of flaps.更多还原