激光多普勒血流仪在游离组织移植中鉴别动脉阻塞与静脉阻塞。
Laser Doppler Flowmetry to Differentiate Arterial From Venous Occlusion in Free Tissue Transfer.
作者信息
Gazyakan Emre, Kao Huang-Kai, Cheng Ming-Huei, Engel Holger
机构信息
Division of Reconstructive Microsurgery, Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Kweishan, Tao-Yuan.
Department of Hand, Plastic and Reconstructive Surgery, BG Clinic Ludwigshafen, University of Heidelberg, Ludwigshafen, Germany.
出版信息
Plast Surg (Oakv). 2019 Nov;27(4):297-304. doi: 10.1177/2292550319876666. Epub 2019 Sep 19.
PURPOSE
The differentiation of arterial versus venous occlusion in free tissue transfers has rarely been described. This study investigated changes in blood flow caused by arterial and venous occlusion and the potential for laser Doppler flowmetry to distinguish between these 2 conditions for better clinical assessment and management of free tissue transfer.
METHODS
Six patients with a mean age of 43.5 years underwent microsurgical free tissue transfer. The venous and arterial blood flow of the vessels and skin flap were monitored using laser Doppler flowmetry with high-frequency pulsed Doppler transducers for vessels and skin before, during, and after clamping the vessels for 10 minutes.
RESULTS
The average decreases in blood flow in the artery and vein caused by clamping were 94.4% and 93.8%, respectively. On average, arterial occlusion demonstrated a sudden drop of 67.7% and venous occlusion caused a decrease of 26.6% on laser Doppler flowmetry in free tissue skin.
CONCLUSION
Using a vessel-holding probe, laser Doppler flowmetry could be used to differentiate between arterial and venous occlusion in free tissue transfer, thereby aiding decision-making for better clinical management.
目的
游离组织移植中动脉阻塞与静脉阻塞的鉴别鲜有报道。本研究调查了动脉和静脉阻塞引起的血流变化，以及激光多普勒血流仪区分这两种情况的可能性，以便更好地对游离组织移植进行临床评估和管理。
方法
6例平均年龄43.5岁的患者接受了显微外科游离组织移植。使用高频脉冲多普勒换能器，通过激光多普勒血流仪在血管夹闭前、夹闭期间和夹闭后10分钟监测血管和皮瓣的静脉和动脉血流。
结果
夹闭导致动脉和静脉血流平均减少分别为94.4%和93.8%。平均而言，在游离组织皮肤的激光多普勒血流仪检查中，动脉阻塞表现为突然下降67.7%，静脉阻塞导致下降26.6%。
结论
使用血管夹持探头，激光多普勒血流仪可用于区分游离组织移植中的动脉和静脉阻塞，从而有助于做出决策以实现更好的临床管理。
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