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微脉冲血氧饱和度测定法在实体器官移植中作为组织灌注新检测手段的应用。

The use of micro pulse oximetery as a new detector of tissue perfusion in solid organ transplantation.

作者信息

Rasekhi Alireza, Sharifian Maryam, Kazemi Koroush, Hosseini Seyed Ali Malek

机构信息

Department of Neurology, Shiraz University of Medical Sciences, Shiraz, Iran.

出版信息

Saudi J Kidney Dis Transpl. 2012 Jul;23(4):715-8. doi: 10.4103/1319-2442.98144.

Abstract

Vascular complications are a frequent cause of transplant failure; angiography, duplex sonography, computerized tomography (CT) scan, CT-angiography and microdialysis are the methods that were suggested for the detection of arterial obstruction after transplantation. In this study, we suggest a new method. Eight healthy adult dogs were included in the trial. All cases were operated by the same surgeon and the liver, pancreas, spleen, kidney and bowel tissue were exposed. The probes of the device, which were designed for this study, were inserted on the organ parenchyma. The device, a neonatal pulse oximeter, has two probes that were fixed by a holder in front of each other; the distance between the probes was changeable via a spring. The pulse and the oxygen saturation of the tissue were measured initially. Following this, by inducing ischemia with vessel clamping, the pulse and the oxygen saturation were measured again. The collected data were analyzed under the supervision of a statistician. In the liver and spleen, we could not detect a clear pulse wave and oxygenation. On the other hand, in the pancreas, kidney and bowel, we detected a clear curve of oxygenation and pulse in all cases. Obstruction caused significant changes: the pulse was not detected and the oxygenation decreased significantly. Our study suggests that with early diagnosis, the surgeons can detect arterial occlusion immediately and early intervention may decrease parenchymal damage. This study is the first experience in this field, and these findings need to be validated with further studies.

摘要

血管并发症是移植失败的常见原因;血管造影、双功超声、计算机断层扫描(CT)、CT血管造影和微透析是被建议用于检测移植后动脉阻塞的方法。在本研究中,我们提出一种新方法。八只健康成年犬被纳入试验。所有病例均由同一位外科医生进行手术,暴露肝脏、胰腺、脾脏、肾脏和肠组织。为本研究设计的设备探头插入器官实质。该设备是一种新生儿脉搏血氧仪,有两个探头,由一个固定器固定在彼此前方;探头之间的距离可通过弹簧改变。最初测量组织的脉搏和血氧饱和度。在此之后,通过血管夹闭诱导缺血,再次测量脉搏和血氧饱和度。收集的数据在统计学家的监督下进行分析。在肝脏和脾脏中,我们未检测到清晰的脉搏波和氧合情况。另一方面,在胰腺、肾脏和肠中,我们在所有病例中均检测到清晰的氧合曲线和脉搏。阻塞导致显著变化:未检测到脉搏且氧合显著下降。我们的研究表明,通过早期诊断,外科医生可立即检测到动脉闭塞,早期干预可能减少实质损伤。本研究是该领域的首次经验,这些发现需要进一步研究加以验证。

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