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-  2015 

吲哚菁绿血管造影在皮瓣手术中的应用价值

DOI: doi:10.7507/1002-1892.20150241

Keywords: 吲哚菁绿, 血管造影, 皮瓣, 并发症

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Abstract:

目的探讨皮瓣手术中应用吲哚菁绿血管造影以减少皮瓣术后相关并发症的可行性及价值。 方法2014年2月-12月,在14例皮瓣手术中行吲哚菁绿血管造影,评价皮瓣血流灌注情况,并对应调整手术方案。男2例,女12例;年龄23~58岁,平均35.5岁。乳房再造11例,其中采用腹壁下动脉穿支(deep inferiorepigastric artery perforator,DIEP)皮瓣3例,横行腹直肌肌皮瓣(transverse rectus abdominis myocutaneous flap,TRAM)4例、带蒂TRAM及对侧游离TRAM 2例、背阔肌肌皮瓣联合假体2例;背阔肌肌皮瓣修复胸壁软组织缺损1例;带蒂股深动脉穿支(profunda artery perforator,PAP)皮瓣修复大腿后方瘢痕挛缩1例;膝降动脉穿支皮瓣修复膝关节内侧缺损1例。皮瓣切取范围9 cm×6 cm~26 cm×12 cm。 结果术中共行吲哚菁绿血管造影32次,未出现造影相关并发症。其中5例根据吲哚菁绿血管造影结果调整手术方案,其中3例(1例TRAM、1例DIEP皮瓣、1例PAP皮瓣)切除皮瓣血流灌注不良部分,2例拟行TRAM乳房再造者改为带蒂TRAM和对侧游离TRAM;其余患者按照术前设计顺利切取皮瓣修复创面。术后患者均获随访,随访时间1~9个月,平均5个月。除1例PAP皮瓣发生远端坏死外,其余皮瓣均顺利成活,无切口感染、脂肪液化等并发症发生。 结论皮瓣手术中行吲哚菁绿血管造影能实时评价皮瓣血流灌注情况,及时调整手术方案,保证术后皮瓣顺利成活

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