The Predictive Value of the Laser Doppler Flowmeter for Postoperative Microvascular Monitoring
The Predictive Value of the Laser Doppler Flowmeter for Postoperative Microvascular Monitoring
复制标题
DOI：
10.1097/00000637-199310000-00004
复制
发表时间：
1993-10
影响因子：
1.5
通讯作者：
S. Hovius;L. V. Van Adrichem;H. D. Mulder;R. van Strik;J. C. van der Meulen
中科院分区：
文献类型：
--
作者：
S. Hovius;L. V. Van Adrichem;H. D. Mulder;R. van Strik;J. C. van der Meulen
在微血管手术中，可靠的术后监测是改善血管受损后再探查成功率低的必要条件。本研究对激光多普勒血流仪的应用进行了评价。自1985年11月至1988年1月，对79例微血管手术进行术后监测。其中包括34例患者的45例再植和血管重建，以及34例游离血管化组织移植。在再植和血运重建术组，激光多普勒血流读数在血管良好和循环受损患者之间有统计学意义的差异（p<0.001）。在这项研究中，可以为再植和血运重建定义一个可靠的临界（警报）值，灵敏度为93%，特异性为94%。这个临界报警值可以根据个别外科医生对再探查的态度来调整。游离血管化组织移植患者的激光多普勒血流特征相似；然而，这部分研究中的数字太小，无法定义可靠的临界报警值。建议使用激光多普勒流量计对微血管吻合后的组织进行术后评估，因为它可以在早期显示血管闭塞，值得再次探查。
Reliable postoperative monitoring in microvascular surgery is necessary to improve the low success rate of reexploration after vascular compromise. The use of laser Doppler flowmetry has been evaluated in this study. From November 1985 to January 1988, 79 microvascular operations were monitored postoperatively. These consisted of 45 replants and revascularizations in 34 patients, as well as 34 free vascularized tissue transfers. In the replant and revascularization group, a statistically significant difference in laser Doppler flowmetry readings has been demonstrated between well-vascularized and circulatory impaired patients (p<0.001). In this study a reliable critical (alarm) value could be defined for replants and revascularizations with a sensitivity of 93% and a specificity of 94%. This critical alarm value can be adjusted according to the individual surgeon's attitude toward reexploration. Similar laser Doppler flowmetry characteristics were seen in patients with free vascularized tissue transfers; however, the numbers in this part of the study were too small to define reliable critical alarm values. The laser Doppler flowmeter is recommended for the postoperative evaluation of tissue after microvascular anastomoses, as it indicates vascular occlusion at an early stage where reexploration is worthwhile.