近红外光谱技术对恒河猴腓骨瓣血管栓塞模型血运监测的实验研究

Study on the reliability of NIRS to monitor fibular flaps on Rhesus monkeys

目的探讨近红外光谱技术对局部组织中血流量和血氧饱和度动态变化的敏感性和可行性。方法从2008年6月至10月，选用6只成年雄性恒河猴．模仿临床腓骨瓣的制备方法．制备恒河猴腓骨瓣．依次夹闭动脉、静脉以及动、静脉同时夹闭，建立腓骨瓣动脉、静脉以及动脉和静脉全栓塞模型，利用第三代近红外光谱血氧监测仪（TSAH-100）对腓骨瓣局部脱氧血红蛋白（cHb）、含氧血红蛋白（cHbO2）和血氧饱和度（rSO2）进行监测，并进行统计学分析。结果在动脉、静脉及动脉和静脉全夹闭的情况下，cHb、cHb02和rsO2均出现显著变化，cHb和cHbO2测量初始值在各栓塞状态下均为0μmol/L，rS02在动脉栓塞、静脉栓塞和动、静脉栓塞中的测量初始平均值分别为51．6％、54．3％和56．8％。将cHb、cHbO2和rsO2在各栓塞模型中的最大平均变化值与初始值相比，差异均有统计学意义（P〈0．05）。在动脉栓塞、静脉栓塞及动脉和静脉全栓塞模型中，分别将6s、18s和8s后rsO2值与初始值比较．差异有统计学意义（P〈0．05）。结论近红外光谱血氧监测仪对局部厚度小于2．Ocm组织的rsO2和血流灌注的变化敏感可靠．可将其应用于临床上埋藏深度小于2．0cm游离埋藏皮瓣的术后血运监测。

Objective To confirm the sensitivity and validity of near-infrared spectroscopy （NIRS） technology to detect the dynamic changes of blood vohnne and regional tissue oxygen saturation （rSO2）. Methods Six fibular flaps on Rhesus monkeys were raised simulating a clinical operation. Third generation of NIRS oxygen saturation oximeter （TSAH-100） was employed on Rhesus monkeys＇ fibular flaps when its dominant artery and vein were blocked respectively or simultaneously, and then their relative changes of blood volume and oxygen saturation were observed and recorded in June, 2008 to October. 2008. Results The statistic resulls showed that concentration of deoxygenated hemoglobin （cHb）. concentration of oxyhe moglobin （cHbO2） and rSO2 had rapid, apparent and distinct changes respectively in the case of arterial occlusion, venous occlusion and total occlusion. The initial values of cHb and cHbO2 of 3 models were 0 μmol/L,. Meanwhile, the initial values of rSO2 in artery embolism, vein embolism aud arteriovenous embolism were 51.6% ,54.3% and 56.8%. respectively. The maximum variations of cHb, cHbO2, and rSO2 in 3 models indicated significant difference compared with initial values（P〈0.05 ）, Ihe values of rSO2 after 6 s, 18 s and 8 s in 3 models had significant difference compared with initial values respectively （P〈0.05）. Conclusion The TSAH-100 based on NIRS technology is an extraordinarily sensitive and reliable method to monitor the changes of oxygen saturation and blood perfusion in local tissue for buried tlap within a depth of 2.0 cm.