上海交通大学学报（医学版）

上海交通大学学报(医学版) ›› 2020, Vol. 40 ›› Issue (10): 1420-1424.doi: 10.3969/j.issn.1674-8115.2020.10.021

• 论著·临床研究 • 上一篇    下一篇

红外热成像术导引下扩张额部优势穿支皮瓣行鼻再造术研究

肖文天，李青峰，章一新   

  1. 上海交通大学医学院附属第九人民医院整复外科，上海 200011
  • 出版日期:2020-10-28 发布日期:2020-11-27
  • 通讯作者: 章一新，电子信箱：zhangyixin6688@163.com。
  • 作者简介:肖文天（1994—)，男，住院医师，博士；电子信箱：drxiaoneo@hotmail.com。
  • 基金资助:
    上海市科学技术委员会优秀技术带头人计划（18XD1423700）；上海市教育委员会高峰高原学科建设计划（20152227）；上海交通大学医学院附属第九人民医院临床研究型多学科诊疗团队建设（2017-1-007）；上海交通大学医学院附属第九人民医院临床研究助推计划（JYLJ027）。

Research on nasal reconstruction using expanded forehead flap with the dominant perforator under the guidance of infrared thermography

XIAO Wen-tian, LI Qing-feng, ZHANG Yi-xin   

  1. Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China
  • Online:2020-10-28 Published:2020-11-27
  • Supported by:
    Outstanding Professional and Technical Leader Program of Shanghai Municipal Science and Technology Commission (18XD1423700); Shanghai Municipal Education Commission—Gaofeng Clinical Medicine Grant Support (20152227); Clinical Multi-Disciplinary Team Research Program of Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine (2017-1-007); Clinical Research Program of Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine (JYLJ027).

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摘要： 目的·探究利用红外热成像术（infrared thermography, IRT）探测优势的滑车上动脉在使用额部扩张皮瓣行鼻再造术中的应用效果。方法·选取15例拟使用额部扩张皮瓣行鼻再造术的患者，使用IRT标记扩张皮瓣中走行的滑车上动脉，明确血管是否缺失以及双侧的血管质量是否对称，标记结果使用彩色超声多普勒血流成像进行验证。根据术前的血管标记结果，使用优势一侧的滑车上动脉为血管蒂设计、切取皮瓣。结果·15例皮瓣中走行的滑车上动脉均可利用IRT标记，其中10例双侧的血管口径、流速对称，2例存在单侧血管缺如，3例皮瓣中双侧的血管质量不对称。以优势一侧的滑车上动脉为蒂设计、切取大小为4 cm×6 cm ～ 6.5 cm×13 cm的皮瓣，术后皮瓣均存活。结论·额部扩张皮瓣中存在双侧血管不对称的可能，使用IRT可以快速辨别其中优势的滑车上动脉，保障皮瓣切取后的血运。

关键词: 红外热成像术, 额部扩张皮瓣, 血管导航, 鼻再造, 滑车上动脉

Abstract:

Objective · To explore the effect of infrared thermography (IRT) on detecting the dominant supratrochlear artery in nasal reconstruction using expanded forehead flaps. Methods · Fifteen patients who planned to use the expanded forehead flap for nasal reconstruction were selected. Preoperatively, IRT was used to mark the supratrochlear artery in the expanded flap to determine whether the blood vessel was missing and whether the quality of the bilateral vessels was symmetrical. The results were verified by color ultrasonic Doppler blood flow imaging. According to the result of preoperative vessel detection, the supratrochlear artery on the dominant side was selected to design the flap. Results · All 15 flaps could be marked with IRT to identify the supratrochlear artery. Among them, 10 cases had symmetrical vascular calibers and flow velocity, 2 cases had unilateral vascular deficiency, and 3 cases had asymmetric vascular quality. The supratrochlear artery on the dominant side was used as the pedicle, and flaps with the size of 4 cm×6 cm- 6.5 cm× 13 cm were excised, and all flaps survived well. Conclusion · There is the possibility of bilateral vascular asymmetry in the expanded forehead flap. The use of IRT can quickly identify the dominant supratrochlear artery and ensure the blood flow after the flap is elevated.

Key words: infrared thermography(IRT), expanded forehead flap, vascular navigation, nasal reconstruction, supratrochlear artery

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