摘要
目的探讨红外热成像装置在皮瓣移植围术期监测的应用价值及使用技巧。方法采用便携式红外热像仪FLIRONE pro,在16例皮瓣移植患者术前、术中和术后对皮瓣及周围部位进行拍摄,并使用FLIRTools软件对拍摄的热像图进行分析和局部温度测量;同时,采用彩色多普勒超声对穿支血管进行定位,比较两种检测方法的检测结果。结果皮瓣移植术前的红外热像图可准确定位血管位置,血管走行区域皮肤温度高于周围,在热像图上呈现"亮点"或"亮线",其结果与彩色多普勒超声所示一致。术中热像图可通过测定皮瓣各区域温度,辅助判断蒂部血管是否通畅,以及皮瓣远端血运情况。术后的热像图可用于监测皮瓣血供,通过比较皮瓣与周围正常皮肤温度,以及皮瓣温度变化,观察皮瓣微循环,有助于早期发现皮瓣血运障碍,从而及时采取干预措施。结论红外热成像技术是一种无创、经济、简便、直观、准确的辅助检测手段,对于皮瓣移植术前血管定位及术中、术后血运监测具有较高应用价值。
Objective To explore the application and techniques of dynamic infrared thermography device for perioperative monitoring of skin flap transplantation.Methods Thermal images were obtained by FLIR ONE pro camera,a portable thermal imager which can take infrared thermographs and optical photographs at the same time.The flaps and surrounding areas were photographed pre-operation,intra-operation and post-operation.Then the thermal images were analyzed by software FLIR Tools and the temperature of several spots or regions on the flaps were measured.At the same time,color Doppler ultrasound was also performed to locate the perforator vessels.The results of these two detecting methods were compared.A total of 16 clinical applications were performed.Results Before flap transplantation,the position of the blood vessels could be accurately located on thermal images.The skin temperature of the blood vessels running area was higher than the surrounding area,usually with the"hot spots"or"hot lines"on the thermal images.The result was confirmed by color Doppler ultrasound in all 16 cases.Intraoperative thermography could be used to determine whether the pedicle vessels were patency and observe the blood supply of distal flaps,by measuring the temperature of different regions on the flap.Postoperative thermal images were efficient in monitoring the blood supply of the flaps.By means of comparing the temperature of the flap and the surrounding normal skin,and recording the change of flap temperature over time,the flap microcirculation could be observed,which helps to detect the flap blood flow disorder early,so that interventions can be taken in time.Conclusion Dynamic infrared thermography is a non-invasive,economical,simple,intuitive and accurate auxiliary detection method.It’s practical in vascular localization and sensitive in intraoperative and postoperative blood supply monitoring.
作者
熊哲祯
许律廷
刘凯
XIONG Zhezhen;XU Luting;LIU Kai(Department of Plastic and Reconstructive Surgery,Shanghai Ninth People's Hospital,Shanghai Jiaotong University School of Medicine,Shanghai 200011,China;Kings Mill Hospital,Mansfield Road,Sutton-in-Ashfield,NG174JL,United Kingdom)
出处
《组织工程与重建外科杂志》
2018年第6期331-334,共4页
Journal of Tissue Engineering and Reconstructive Surgery
关键词
红外热成像
皮瓣移植
围术期
Dynamic infrared thermography
Skin flap transplantation
Perioperative period