应用近红外光组织血氧监护仪监测再植手指血液灌注情况的临床研究

Clinical Study of Near-infrared Spectroscopy in Monitoring the Blood Perfusion of Replantation

目的介绍一种新的断指再植术后血液灌注的监测方法，并进行临床可行性研究，提供相关的研究数据以供参考。方法使用近红外光组织血氧监护仪对45例断指再植术后患者血液灌注情况进行持续性无创监测72h。结果在监测的45例断指再植患者中，42例再植成功，其中38例术后血运平稳，血氧饱和度测量值最低28％、最高99％、平均75％，4例出现血管危象但最终成活，3例再植失败。对再植成功患者连续监测72h后立即对健侧相同的手指进行24h监测，血氧饱和度测量值最低76％、最高99％、平均90．5％。结论临床研究表明，此装置无创、操作简单、结果可靠，其最突出的优点是可进行动态性的血循环监测且客观、灵敏。因此，可用于断指再植的术后监测。

Objective To introduce a new method of post-operative monitoring for digit replantation, to research the clinical reliability, and to provide the relative research data. Methods Using a near-infrared optical device, a continusious study on post-operative non-invasive monitoring of finger blood perfusion has been conducted for 72 hours. Results Totally conducted 45 cases, including 42 cases replanted successfully and 3 cases unsuccessfully. Inside the 42 cases,38 cases＇ data are steady , with the lowest tissue oxygen saturation （StO2） 28%,the highest StO2 99%, and the average StO2 75%.And 3 cases has vascular crisis but ultimately alive.After continurious monitoring of replanted digits for 72 hours, monitor the same finger of the other hand of the patients for another 24 hours. Conclusion This research indicate that this method is non-invasive,easy to conduct and the result is reliable. It＇s advantage is that it can monitor constantly and the result is sensitive and objective. So it can be used in post-operative monitoring for digit replantation.