激光多普勒血流仪与经皮氧分压测量在需要截肢的血管病变患者中的比较。

A comparison of laser Doppler fluxmetry and transcutaneous oxygen pressure measurement in the dysvascular patient requiring amputation.

作者信息

Mars M, McKune A, Robbs J V

机构信息

Department of Physiology, University of Natal Medical School, South Africa.

出版信息

Eur J Vasc Endovasc Surg. 1998 Jul;16(1):53-8. doi: 10.1016/s1078-5884(98)80092-0.

DOI:10.1016/s1078-5884(98)80092-0

PMID:9715717

Abstract

OBJECTIVE

To determine the predictive power of laser Doppler fluxmetry (LDF), both heated and unheated, as a preoperative investigation of wound healing potential in dysvascular patients requiring amputation, by comparison with transcutaneous oxygen pressure measurement (TcpO2) and the limb to chest TcpO2 index.

METHODS

Thirty-five non-diabetic patients with peripheral vascular disease were investigated before amputation. Heated and unheated LDF and heated TcpO2 measurements were taken on the chest wall and at the routine above-knee, below-knee and mid-foot amputation levels. Wound healing potential was evaluated against a TcpO2 index value of 0.55 and on clinical outcome.

RESULTS

A heated LDF value of 4.9 arbitrary units (au) was shown by receiver-operator characteristic curve to have the best predictive power, with an overall accuracy for preoperative prediction of wound healing of 91.4%, and a predictive value for wound failure of 89%. Based on the heated LDF of 4.9 au, review of 26 amputations performed shows the overall accuracy for preoperative prediction of wound healing of 92.3%, a predictive value for wound healing of 100%, and a predictive value for wound failure of 62.5%.

CONCLUSION

A heated LDF value of 4.9 au appears to be a useful predictor of the potential of an amputation site to heal.

摘要

目的

通过与经皮氧分压测量（TcpO2）和肢体与胸部TcpO2指数相比较，确定加热和未加热的激光多普勒血流仪（LDF）作为术前评估需要截肢的血管病变患者伤口愈合潜力的预测能力。

方法

对35例非糖尿病外周血管疾病患者在截肢前进行研究。在胸壁以及常规的膝上、膝下和足中部截肢水平进行加热和未加热的LDF测量以及加热的TcpO2测量。根据TcpO2指数值0.55和临床结果评估伤口愈合潜力。

结果

通过受试者工作特征曲线显示，加热的LDF值为4.9任意单位（au）时具有最佳预测能力，术前预测伤口愈合的总体准确率为91.4%，伤口愈合失败的预测值为89%。基于4.9 au的加热LDF，对26例已进行的截肢手术进行回顾显示，术前预测伤口愈合的总体准确率为92.3%，伤口愈合的预测值为100%，伤口愈合失败的预测值为62.5%。