Shan Xiao-feng, Cai Zhi-gang, Yu Guang-yan, Li Yue, Ding Hai-shu
Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, 100081 Beijing, China.
Zhonghua Kou Qiang Yi Xue Za Zhi. 2008 Jul;43(7):398-401.
To study the change of tissue oxygen index (TOI) by non-invasive near infrared spectroscopy (NIRS) and to investigate the blood flow variety of fibula flaps after operation.
Thirty-six patients who accepted fibula flap reconstruction were chosen as subjects. Authors measured the TOI of the fibula flaps and the control side every four hours in the first twenty-four hours, and measured these positions with the intermittence of twelve hours from second to eighth day after operation.
Thirty-five flaps were successful and one failed. The TOI of fibula flaps shortly after operation was significantly lower than that before the operation( P<0.05). In the successful cases the TOI of fibula flaps and the control sides was fluctuated from 50.0% to 72.0%. The TOI of fibula flaps was significantly lower than that of the control sides within 144 hours after operation(P<0.05). After 144 hours the TOI was equal to that of the control side. TOI of the failed case decreased dramatically.
NIRS can reliably indicate the change of TOI in buried flaps and detect ischemia at the early stage. The TOI of the fibula flaps depress at the early stage and returns to normal at 144 hours after operation.
采用无创近红外光谱技术（NIRS）研究组织氧合指数（TOI）的变化，并探讨腓骨肌皮瓣术后血流量的变化情况。
选取36例行腓骨肌皮瓣重建术的患者作为研究对象。在术后24小时内，每4小时测量一次腓骨肌皮瓣及其对照侧的TOI；术后第2天至第8天，每12小时测量一次上述部位。
35例皮瓣成活，1例皮瓣坏死。术后即刻腓骨肌皮瓣的TOI显著低于术前（P<0.05）。在皮瓣成活的病例中，腓骨肌皮瓣及其对照侧的TOI在50.0%至72.0%之间波动。术后144小时内，腓骨肌皮瓣的TOI显著低于对照侧（P<0.05）。144小时后，TOI与对照侧相当。皮瓣坏死病例的TOI急剧下降。
NIRS能够可靠地反映埋藏皮瓣中TOI的变化，并能早期检测出缺血情况。腓骨肌皮瓣的TOI在术后早期降低，术后144小时恢复正常。
