Machens H G, Pallua N, Mailaender P, Pasel J, Frank K H, Reimer R, Berger A
Clinic for Plastic, Hand and Reconstructive Surgery, Hannover Medical School, Germany.
Microsurgery. 1995;16(12):808-17. doi: 10.1002/micr.1920161208.
The purpose of this study was to compare the hydrogen clearance technique (HCT) with two different, well-established techniques, i.e., the laser Doppler flowmetry (LDF) and the Erlangen micro-lightguide spectrophotometer (EMPHO), for tissue blood flow measurements in an experimental setting. For the animal experiments, we chose a rat model for arterial and venous flap thrombosis, using the epigastric groin flap. Forty male dark Aguty rats were included in the study. The animals were divided into eight groups, each with a different vascular thrombotic model. HCT was used to collect 1,467 measurements, and 2,934 graphs were recorded; 27 measurements (54 graphs) had to be discarded due to faulty electrode placements and electronic noise. In 19 of the 27 discarded measurements the cause of failure was moving of the awaking animal with disruption of the decay signal. The LDF and EMPHO measurements were performed continuously during each measuring phase. Simple and multiple linear regression and paired t-tests were used to compare the three techniques. The reproducibility of registered blood flow values in phases 1, 3, 6 and 7 varied between 7.8% and 13.6% which is in about the same range as LDF and EMPHO. We could not find a significant difference between the three techniques in this regard. The correlation coefficient for HCT and LDF was r = 0.89. For HCT and EMPHO we found r = 0.67. Sensitivity and specificity values for HCT were both 1.0 in detecting arterial and venous flap thrombosis; for LDF we found values of 0.89 and 0.92, respectively. Sensitivity and specificity values for EMPHO were 0.92 and 0.95, respectively. After careful evaluation of three different techniques (HCT, LDF, and EMPHO) for measurements of local tissue blood flow we came to the conclusion that HCT must be favoured as a reliable tool for quantitative measurement of local tissue blood flow and early diagnosis of arterial and venous flap thrombosis.
本研究的目的是在实验环境中，将氢清除技术（HCT）与两种不同的成熟技术，即激光多普勒血流仪（LDF）和埃尔朗根微光导分光光度计（EMPHO）进行比较，以测量组织血流量。在动物实验中，我们选择了一个使用腹股沟上腹皮瓣的大鼠动静脉皮瓣血栓形成模型。40只雄性黑色阿古蒂大鼠被纳入研究。动物被分为八组，每组具有不同的血管血栓形成模型。使用HCT收集了1467次测量数据，并记录了2934张图表；由于电极放置错误和电子噪声，有27次测量（54张图表）不得不被丢弃。在27次被丢弃的测量中，有19次失败的原因是清醒动物移动导致衰减信号中断。在每个测量阶段，LDF和EMPHO测量均连续进行。使用简单和多元线性回归以及配对t检验来比较这三种技术。在第1、3、6和7阶段记录的血流值的可重复性在7.8%至13.6%之间，这与LDF和EMPHO大致相同。在这方面，我们未发现这三种技术之间存在显著差异。HCT与LDF的相关系数为r = 0.89。对于HCT和EMPHO，我们发现r = 0.67。HCT在检测动静脉皮瓣血栓形成时的敏感性和特异性值均为1.0；对于LDF，我们分别发现值为0.89和0.92。EMPHO的敏感性和特异性值分别为0.92和0.95。在对用于测量局部组织血流量的三种不同技术（HCT、LDF和EMPHO）进行仔细评估后，我们得出结论，HCT作为定量测量局部组织血流量和早期诊断动静脉皮瓣血栓形成的可靠工具更具优势。
