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	近红外光谱监测系统在游离腓骨瓣血运检测中的应用研究
	蔡志刚 ; 张杰 ; 张建国 ; 赵福运 ; 于国霞 ; 李岳 ; 丁海曙 ; Cai Zhigang ; Zhang Jie ; Zhang Jianguo
	2010-07-15 ; 2010-07-15
会议名称	第四届中国国际暨第七次全国口腔颌面外科学术会议论文集 ; Proceedings of the Fourth International and Seventh National Conference on Oral and Maxillofacial Surgery ; 第四届中国国际暨第七次全国口腔颌面外科学术会议 ; The Fourth International and Seventh National Conference on Oral and Maxillofacial Surgery ; 中国成都 ; CNKI ; 中华口腔医学会口腔颌面外科专业委员会
关键词	近红外光谱 游离腓骨瓣 血运检测 near-infrared spectroscopy free fibular flap blooding monitoring R782.2
其他题名	Blooding monitoring after free fibular transplantation with non-invasive near-infrared spectroscopy
中文摘要	目的利用空间分辩(SRS)近红外光谱检测系统定量研究血管化游离腓骨移植后,移植组织内局部氧饱和度的变化规律。方法利用4位志愿者的前臂静脉阻断和全阻断实验验证SRS 样机的灵敏度及精确性;利用SRS 样机对40位志愿者双侧下颌骨体及升支共4个部位的局部组织氧饱和度(rSO_2)的正常值分别于上、下午进行测定和分析;利用SRS 样机对41名血管化游离腓骨移植术后移植骨段的氧饱和度,分别于术后即刻至术后24hr 内每4hr 检测1次,从术后第二天至第七天每12hr 进行定时检测1次,并对测定结果进行统计分析通过对现有监测结果的分析。结果SRS 样机在局部组织氧饱和度的检测中具有较高的灵敏度,对rSO_2的变化反应迅速,通常在2分钟达到稳定;正常人下颌骨内局部组织氧饱和度分布均匀,不随部位及测定时间而改变,基本恒定在70%左右;SRS 样机可以相对定量的测定移植腓骨内rSO_2值,术后腓骨瓣的rSO_2水平低于正常组织,平均降低幅度在1.33%-4.25%之间;术后腓骨瓣的rSO_2逐步下降,从术后4小时开始,至8～12小时达到最低点,此时腓骨瓣与对照侧的rSO_2差异最大为4_2%。之后腓骨瓣的rSO_2逐步回升,20小时时接近对照侧的rSO_2值。坏死腓骨瓣的rSO_2可能会下降至较低水平(如<60%),这还有待进一步积累验证。结论近红外光谱技术是一种无创检测埋藏组织瓣血运的良好方法,SRS 系统可得到局部组织氧饱和度的绝对值,对深部游离移植组织血运的判断无疑是较好和较可靠的手段之一,值得在临床推广。; Objective To study the rule of regional tissue oxygen saturation(rSO_2)after the free fibular transplantation with non-invasive near-infrared spectroscopy(NIRS)quantitatively.Methods In order to validated the sensibility and precision,forearm vessel obstructive test wereperformed in 4 volunteers:the rSO_2 of bilateral mandibular body and ramus in 40 volunteers were measured and analyzed using NIRS in themorning and afternoon respectively;the rSO_2 of transplanted fibular flap in 41 cases were measured and analyzed using NIRS after operating indifferent time.Results NIRS has a higher sensibility in the monitoring of rSO_2;The rSO_2 in the normal mandible is equally distributing,themeasured results stabilized in 70%±,and no change with different times and locations.However,the rSO_2 in the translated fibula showed reductioncompared with the control side,and reduced gradually from 4～12hrs post-OP,then the rSO_2 gradually increased,to the twentieth hr post-OP it has nodifferent compared with the contrl side.Conclusions NIRS is a better non-invasive method for blooding monitoring in the translated tissue,especially for the embedded flaps,it can measured the rSO_2,and should be used in this fields widely in the future.
会议录出版者	《中国口腔颌面外科杂志》编辑部
语种	中文 ; 中文
内容类型	会议论文
源URL	[http://hdl.handle.net/123456789/70266]
专题	清华大学
推荐引用方式 GB/T 7714	蔡志刚,张杰,张建国,等. 近红外光谱监测系统在游离腓骨瓣血运检测中的应用研究[C]. 见:第四届中国国际暨第七次全国口腔颌面外科学术会议论文集, Proceedings of the Fourth International and Seventh National Conference on Oral and Maxillofacial Surgery, 第四届中国国际暨第七次全国口腔颌面外科学术会议, The Fourth International and Seventh National Conference on Oral and Maxillofacial Surgery, 中国成都, CNKI, 中华口腔医学会口腔颌面外科专业委员会.

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