Perbeck L, Lindquist K, Liljeqvist L
Dis Colon Rectum. 1985 Dec;28(12):931-6. doi: 10.1007/BF02554310.
Fluorescein flowmetry implies the measurement of capillary blood flow, expressed as an index between the maximum fluorescence after the first circulatory passage of sodium fluorescein (NaF) and the rise time, defined as the time interval between ten and 90 percent of the maximum fluorescence. A mathematic model based on fluorescein flowmetry was deduced to distinguish a mucosal and muscular blood flow in an intact (unopened) intestine during surgery in man. The hypothesis was that if, at a certain point in time, there is a fixed relationship between the seromuscular fluorescence and the mucosal maximum fluorescence, obtained during the first circulatory passage of NaF, and if the rise times were equal, then a mucosal blood flow could be calculated based on the seromuscular fluorescence. The model was tested in intestinal anastomoses on 16 patients. A fixed relationship between the numeric value of the mucosal maximum fluorescence and the seromuscular fluorescence was found. After five minutes, the ratio was 1:1 and the correlation coefficient at its highest (0.97). It was also found that the rise times were practically identical (r = 0.92). The validity of the model was then tested by comparing it with fluorescein flowmetry, and the correlation coefficient was 0.85. The model was therefore accepted and named indirect mucosal fluorescein flowmetry. Indirect mucosal fluorescein flowmetry was applied to measure blood flow in pelvic pouches in 14 patients, and fluorescein flowmetry in the ileoanal anastomoses in eight patients. The mucosal blood flow in the reservoir, compared with the normal intestine, was reduced to 58 percent if the ileocolic artery or distal branches of the mesenteric artery were ligated, and to 88 percent if the vessels were left intact (P less than 0.05). In the ileoanal anastomosis the mucosal blood flow was reduced to 23 percent compared with the normal intestine (P less than 0.01). The results suggest that stretching and compressing the mesentery might be critical for circulation in the ileoanal anastomoses.
荧光素血流测定法是指对毛细血管血流的测量，以荧光素钠（NaF）首次循环通过后的最大荧光与上升时间之间的指数表示，上升时间定义为从最大荧光的10%到90%之间的时间间隔。推导了一个基于荧光素血流测定法的数学模型，用于在人体手术过程中完整（未打开）的肠道中区分黏膜血流和肌肉血流。假设是，如果在某个时间点，在NaF首次循环通过期间获得的浆膜肌层荧光与黏膜最大荧光之间存在固定关系，并且上升时间相等，那么可以根据浆膜肌层荧光计算黏膜血流。该模型在16例患者的肠吻合术中进行了测试。发现黏膜最大荧光数值与浆膜肌层荧光之间存在固定关系。五分钟后，该比例为1:1，相关系数最高（0.97）。还发现上升时间实际上是相同的（r = 0.92）。然后通过将该模型与荧光素血流测定法进行比较来测试其有效性，相关系数为0.85。因此该模型被接受并命名为间接黏膜荧光素血流测定法。间接黏膜荧光素血流测定法用于测量14例患者盆腔袋中的血流，以及8例患者回肠肛管吻合术中的荧光素血流测定。与正常肠道相比，如果回结肠动脉或肠系膜动脉的远端分支被结扎，储袋中的黏膜血流减少到58%，如果血管保持完整，则减少到88%（P < 0.05）。在回肠肛管吻合术中，与正常肠道相比，黏膜血流减少到23%（P < 0.01）。结果表明，肠系膜的拉伸和压缩可能对回肠肛管吻合术的血液循环至关重要。
