高频彩色多普勒超声在皮瓣修复术前浅表供皮区血供监测及皮瓣设计中的评估价值

目的 探讨高频彩色多普勒超声(color Doppler ultrasound,CDUS)在皮瓣修复术前浅表供皮区血供监测及皮瓣设计中的评估价值.方法 选取2017年5月至2019年11月拟在南阳市某三甲医院接受浅动脉穿支皮瓣修复的43例患者为研究对象,术前均借助高频彩色多普勒超声仪对浅表供皮区血管数量、走向、血管腔直...

The evaluation value of high-frequency color Doppler ultrasound in monitoring the blood supply of the superficial donor area and the design of the flap before flap repair

Objective To explore the evaluation value of high-frequency color Doppler ultrasound(CDUS)in the monitoring of the blood supply of the superficial donor area and the design of the flap before flap repair.Methods From May 2017 to November 2019,43 patients who were planned to undergo superficial artery perforator flap repair in a tertiary hospital in Nanyang City were selected as the research objects.The superficial skin was donated by high-frequency color Doppler ultrasound before surgery.The number,direction,diameter of the vessel lumen,the presence or absence of vascular sclerosis or stenosis,the presence or absence of abscess,inflammation,etc.are screened to guide the design of superficial artery perforator flaps,and compare them with the actual measurements during the operation,and analyze CDUS The sensitivity,specificity,positive predictive value and negative predictive value of preoperative blood supply monitoring in the superficial skin donor area.Results Among the 43 flap repair patients monitored by CDUS before surgery,29 were repaired with breast cancer flaps and 14 were repaired with oral cancer flaps.CDUS detected a total of 159 blood vessels in the donor area flap before operation,each with 1 to 4 perforating branches,which is basically the same as the actual situation during the operation.The monitoring sensitivity of preoperative CDUS monitoring is 84.21%and the specificity is 100%.The positive predictive value was 100%,and the negative predictive value was 45.45%.There was no statistically significant difference between the diameters of the main nutrient vessels of the donor flaps monitored by CDUS before operation and the intraoperative anatomical measurements(P>0.05).Postoperative follow-up of 43 cases of transplanted skin flaps were alive,the blood supply of the transplanted flaps was good,and there was no flap necrosis,and the patients could accept the scarring effect of the transplanted flaps.Conclusion High-frequency color Doppler ultrasound can accurately assess the blood supply of the superficial skin donor area,and has high sensitivity for the selection and detection of the main nutritional blood vessels of the transplanted skin flap.It can be used as an important reference method for the design of the preoperative skin flap,and its clinical application value is relatively high.high.