摘要
目的探讨ICG-FLOW800血流动力学分析技术(ICG-FLOW800技术)在颅内外血流重建中的应用和评估作用以及临床意义。方法回顾性分析2018年1月至2019年9月453例接受颅内外血流重建治疗患者的临床资料,根据ICG-FLOW800技术评估结果及时间-荧光强度曲线进行受体血管选择,吻合后评估血管通畅情况及手术区域灌注改善情况,并与术后情况进行比较。结果纳入453例患者在接受颅内外血流重建手术中,ICG-FLOW800技术评估结果显示局部灌注改善425例(93.82%)。术后无并发症患者340例(无并发症组),出现新发神经功能症状患者113例(并发症组),癫癎47/453例(10.38%),新发梗死11/453例(2.43%),新发颅内出血1/453例(0.22%)。有手术并发症患者中,左侧半球67例,右侧半球46例,差异有统计学意义(P=0.037)。ICG-FLOW800技术分析显示,并发症组的ΔTTP略有下降(4.19%对比-0.90%,P=0.559),而ΔCBV (22.45%对比69.41%)与ΔCBF (21.73%对比161.36%)显著升高(P<0.01)。结论颅内外血流重建治疗中,应用ICG-FLOW800技术能够辅助手术决策与受体血管选择,对临床转归与术后管理具有一定的指导作用。
Aim To evaluate the effect and clinical significance of ICG-FLOW800 in surgical revascularization. Methods Clinical data of 453 patients with surgical revascularization in our hospital from January 2018 to September 2019 were retrospectively analyzed. The recipient arteries were selected according to ICG-FLOW800 evaluation results and time fluorescence intensity curve. Anastomosis patency and perfusion improvement of surgical area were compared before and after procedure, and correlated with postoperative conditions. Results Among 453 cases, 425 cases(93.82%) showed improvement of hemodynamic status from ICG-FLOW800. There were 113 cases(24.94%) with newly developed neurological deficits, including 47 cases of epilepsy(10.38%), 11 cases of new infarction(2.43%) and one case of new intracranial hemorrhage(1.55%). In the complication group, 67 cases were operated on the left hemisphere and 46 cases were operated on the right hemisphere, with statistical difference(P=0.037). Hemodynamic analysis of ICG-FLOW800 showed that Δ TTP decreased slightly(4.19% vs.-0.90%, P=0.559), while Δ CBV(22.45% vs. 69.41%) and Δ CBF(21.73% vs. 161.36%) were significantly increased in the complication group(P<0.01). Conclusion The application of ICG-FLOW800 technique in surgical revascularization can assist surgical decision-making and recipient vessel selection, which has a certain predicting value in clinical outcome and postoperative management.
作者
张鑫
杨欢
倪伟
雷宇
苏佳斌
许珏凤
顾宇翔
ZHANG Xin;YANG Huan;NI Wei;LEI Yu;SU Jia-bin;XU Jue-feng;GU Yu-xiang(Department of Neurosurgery,Huashan Hospital,Fudan University,Shanghai 200040,China;Neurosurgical Institute of Fudan University,Shanghai 200040,China;*Shanghai Clinical Medical Center of Neurosurgery,Shanghai 200040,China;Shanghai Key Laboratory of Brain Function and Restoration and Neural Regeneration,Shanghai 200040,China;Department of Neurosurgery,Huashan Hospital North,Fudan University,Shanghai 201907,China;Department of Nursing,Huashan Hospital,Fudan University,Shanghai 200040,China)
出处
《中国临床神经科学》
2021年第1期28-35,共8页
Chinese Journal of Clinical Neurosciences
基金
国家自然科学基金(编号:81771237,81801155)
上海市“脑与类脑智能”市级重大科技专项资助(编号:2018SHZDZX03)
张江实验室、上海市卫生健康委先进适宜技术推广项目(编号:2019SY076)
上海市科委产学研医合作项目(编号:19DZ1930304)。
