带蒂横行腹直肌肌皮瓣乳房重建血氧饱和度的近红外光谱技术监测方法

The Near-infrared Spectroscopy Methods for Regional Oxygen Saturation Monitoring in Breast Reconstruction with Pedicled Transverse Rectus Abdominis Myocutaneous Flap

为了建立带蒂横行腹直肌肌皮瓣(Transverse rectus abdominis myocutaneous,TRAM)乳房重建皮瓣血氧饱和度(regional oxygen saturation,rSO_2)的近红外光谱技术监测方法.利用近红外组织血氧参数无损监测仪对围术期TRAM皮瓣进行血氧监测,以对侧乳房作为参照,并将监测结果和临床观察结果进行对比.对侧正常乳房rSO_2在术前、术中、术后无明显变化;在结扎腹壁下血管后,TRAM皮瓣rSO_2先快速下降,然后缓慢回升,最后趋于稳定;皮瓣淤血患者围术期rSO_2变化曲线相应出现异常.近红外光谱技术是用于TRAM乳房重建皮瓣血氧无损监测的有效方法,可反映移植术后皮瓣供血状况,在皮瓣血供异常时可起到提前预警的作用.

To establish the near-infrared spectroscopy monitoring methods for regional oxygen saturation（rSO2） monitoring in breast reconstruction with pedicled transverse rectus abdominis myocutaneous flap.The perioperative rSO2 of TRAM flap was monitored with NIRS noninvasive Monitor and compared with clinical results.The contralateral breast was monitored perioperatively as control group.The perioperative rSO2 of contralateral breast doesn＇t varied significantly.The rSO2 of TRAM flap drops rapidly after ligation of inferior epigastric vessels,and then rises slowly to a stable;the curve of rSO2 for ecchymosed case exhibits abnormal variation in postoperative period.NIRS can be applied on TRAM flap as an effective noninvasive rSO2 monitoring method,reflecting the blood supply of the flap in postoperative period,and can give early warning,when abnormity of blood supply occurs.