眼底荧光血管造影检查的护理

眼底荧光血管造影 (ＦＦＡ)是眼底疾病检查的重要方法之一 ,对眼底病的诊断、治疗有特殊的意义。我院于 1999年 3月至 2 0 0 1年 10月共行ＦＦＡ 2 0 4例 ,护理报告如下。1　临床资料1.1　一般资料　　 2 0 4例中 ,男 137例、女 6 7例 ,年龄 13～ 79岁。经ＦＦＡ检查后诊断为黄斑部病变 6 8例 ,中心性浆液性视网膜脉络膜病变 4 8例 ,视网膜血管阻塞 4 5例 ,糖尿病视网膜病变 39例 ,其他眼底病变 4例。经临床验证诊断符合率为 97.5 %。1.2　检查原理及意义　　ＦＦＡ的基本原理是在眼底照相机上装有特殊滤光片系统 ,将荧光素钠 (造影剂 )注入…     

吲哚菁绿血管造影在颅内外血管搭桥显微手术中的应用

目的 探讨术中吲哚菁绿(ICG)荧光血管造影在颅内外血管搭桥(EC-IC bypass)手术治疗动脉粥样硬化性颈内动脉闭塞(AOICA)中的作用. 方法 回顾性分析AOICA行血管搭桥手术治疗8例患者的经验.吻合前根据造影结果进行选择目的血管,吻合后再行荧光造影评估吻合情况.共搭桥11次,行ICG荧光血管造影25次. 结果 8例手术得益于ICG荧光血管造影,选择了较适宜的目的血管.术中发现2例吻合口狭窄和l例渗漏,经及时拆除缝线和补充缝合等处理好转.术中发现手术区域脑血管显影时间均明显提前.术中未发现ICG的不良反应及过敏反应.术后随访无新发卒中病例均获得良好疗效.术后复查CT血管成像(3D-CTA)或全脑血管造影(DSA),显示吻合血管血流通畅,长期随访未发现再狭窄情况. 结论 ICG荧光血管造影简便易行,具有理想的空间和时间分辨率,可以帮助提高血管搭桥手术的通畅率,从而提高血管搭桥手术的治疗效果.是血管搭桥手术治疗AOICA的重要的术中评估手段.     

眼底荧光血管造影的护理配合

眼底荧光血管造影 ( Fundus Fluorescein An-giography,FFA)是眼底病检查的重要方法之一 ,对眼底病的诊断、预后和疗效有特殊的价值。我院于1 997年 7月至 1 999年 5月 ,共行 FFA 384例 ,现将有关护理配合介绍如下。1　临床资料本组 384例 ,男 2 58例 ,女 1 2 6例 ,年龄 8～ 81岁 ,平均 49岁。共计 2 0多个病种 ,其中中心性浆液性脉络膜视网膜病变 1 1 9例 ;黄斑部病变 95例 ;糖尿病视网膜病变 63例 ;视网膜血管阻塞 56例 ;其他眼底病变 51例 ,诊断正确率 98.7%。2　 FFA的原理和意义1造影用的荧光素钠 ( C2 0 H10 O5Na2 )是一种碳水…     

眼底荧光血管造影不良反应的护理干预

目的探讨预防眼底荧光血管造影不良反应的护理干预方法。方法将252例眼底荧光血管造影患者按入院时间分为对照组与观察组各126例，对照组按常规行眼底荧光血管造影，观察组在此基础上针对造影所致的胃肠道反应、神经系统反应和过敏反应等进行护理干预。结果观察组胃肠道反应和神经系统反应发生率显著低于对照组（均P〈O．01）。结论护理干预有助于眼底荧光血管造影患者安全、顺利完成检查，减少并发症的发生。     

眼底荧光血管造影不良反应的护理干预

目的 探讨预防眼底荧光血管造影不良反应的护理干预方法.方法 将252例眼底荧光血管造影患者按入院时间分为对照组与观察组各126例,对照组按常规行眼底荧光血管造影,观察组在此基础上针对造影所致的胃肠道反应、神经系统反应和过敏反应等进行护理干预.结果 观察组胃肠道反应和神经系统反应发生率显著低于对照组(均P＜0.01).结论 护理干预有助于眼底荧光血管造影患者安全、顺利完成检查,减少并发症的发生.     

吲哚菁绿血管造影在乳腺癌术后乳房重建中的应用

目的探讨乳房重建术中判断组织血供的可视化方法。方法 2014年7月至2015年1月,在4例乳腺癌患者的乳房重建手术中,应用吲哚菁绿(ICG)荧光血管造影技术,在血液灌注可视化的情况下对皮瓣进行修整。结果ICG造影结果与组织血供的临床判断一致,3例患者未出现皮瓣血运障碍,1例患者出现皮瓣部分血运障碍。结论 ICG血管造影可应用于各种类型的乳房切除术后乳房重建,有助于降低皮瓣坏死的发生率和严重性。     

颅内动脉瘤夹闭手术吲哚菁绿不同静脉注射部位显影时间研究

目的 比较颅内动脉瘤夹闭手术中吲哚菁绿不同静脉注射部位与显影时间的关系,以精准配合手术。方法 将112例颅内动脉瘤行开颅夹闭手术患者按吲哚菁绿不同静脉注射部位分为下肢浅静脉(足背静脉)组64例、下肢深静脉(股静脉)组48例;记录两组注射吲哚菁绿过程中的血压、吲哚菁绿显影时间。结果 下肢深静脉组吲哚菁绿显影时间显著短于下肢浅静脉组(P<0.05),两组血压比较差异无统计学意义(均P>0.05)。结论 下肢深静脉注射吲哚菁绿显影时间显著短于下肢浅静脉注射吲哚菁绿,两种注射部位均相对安全;护理人员可根据术者偏好选择静脉注射部位,以提高手术效率。     

测定肝功能时吲哚菁绿清除试验的影响因素分析

目的 探讨肝有效血流量、总胆红素、乙型肝炎、血浆总蛋白等因素对吲哚菁绿排泄试验的影响及可能的机制。方法 通过对127例患者进行吲哚菁绿清除试验,运用多元线性回归的统计学方法,以15 min吲哚菁绿滞留率（ICGR15）为变量,以肝有效血流量（EHBF）、血浆总蛋白（TP）、总胆红素（TBIL）、乙型肝炎（HBV）为自变量,综合分析多个独立因素对吲哚菁绿排泄试验的影响及可能的机制。结果 回归模型ICGR15=25.469-20.520 EHBF+0.044 TBIL+4.217 HBV;F=70.734,P＜0.01;修正R2=0.624,所拟合的回归方程具有统计学意义。结论 吲哚菁绿清除试验与肝有效血流量呈负相关,与总胆红素水平以及是否患有乙型肝炎呈负相关。其机制可能是总胆红素与吲哚菁绿竞争性结合载体,与乙肝导致的肝硬化及其肝血流量变化有关,而血浆总蛋白对吲哚菁绿清除试验的影响尚需进一步研究。     

同步眼底荧光造影的护理配合

总结152例病人实施同步造影护理配合.提出检查前需对病人做好充分的解释工作和药品、物品准备,在检查中及时与医生沟通,观察病人的反应,以确保检查成功及病人安全.     

Intra-Operative Indocyanine Green Angiography of the Parathyroid Gland

Major complications of thyroid and parathyroid surgery are recurrent laryngeal nerve injuries and definitive hypoparathyroidism. The use of intra-operative Indocyanine Green Angiography for confirmation of vascular status of the parathyroid gland is reported here.     

Efficacy of Indocyanine Green Angiography on Microsurgical Subinguinal Varicocelectomy

Objectives: Microsurgical subinguinal varicocelectomy is one of the best treatment modalities for varicoceles related to male infertility and scrotal pain. However, the difficulty in identifying testicular arteries, which should be spared, is a limitation of this technique. To visualize and identify the testicular arteries in spermatic cord during the operation, we examined the efficacy of intraoperative indocyanine green angiography (ICGA), which is regularly used in microsurgical neurosurgery. Methods: After the exposure of the spermatic cord blood vessels, ICG was injected intravenously under a surgical microscope for observing infrared fluorescence in patients to identify and isolate the testicular artery. Results: The testicular artery was clearly identified by ICGA and was able to separate under ICGA view. Thereafter, the varicose veins were repeatedly ligated, while preserving a few lymphatic vessels and the spermatic duct. The preserved arteries were confirmed by repeated ICGA at the end of microsurgical operation. The number of arteries identified by ICGA was greater than the number detected by preoperative computed tomography angiogram. Conclusions: Microsurgical subinguinal varicocelectomy using intraoperative ICGA facilitated safe and quick surgery by enabling the visualization of the spermatic cord blood vessels. This is the first report to indicate the usefulness of vessel visualization by ICGA during microsurgical subinguinal varicocelectomy.     

吲哚菁绿荧光造影在穿支皮瓣微循环检测中的应用

目的评价吲哚菁绿荧光造影在皮瓣微循环检测中的准确性和安全性。方法回顾2014年7月至2018年5月的15例皮瓣手术,术中对皮瓣进行吲哚菁绿荧光造影,将术中造影结果与术中传统主观评估结果进行比较;术后2周记录皮瓣成活情况,将之与术中造影结果进行比较,并记录并发症情况。结果 15例皮瓣造影发现7例皮瓣存在微循环问题,传统主观观察法仅发现2例存在微循环障碍。其中,3例皮瓣在处理后再次造影仍提示有局部循环障碍,术后这3例皮瓣均发生局部坏死,坏死区域与术中造影"暗区"基本相符。所有术中造影患者术后均未出现相关并发症。结论吲哚菁绿荧光造影检测皮瓣灌注情况的准确性高,对皮瓣微循环障碍的敏感性高,可有效降低皮瓣术后局部坏死发生率,在临床应用中具有一定的实用价值。     

Indocyanine Green Tissue Angiography Can Reduce Extended Bowel Resections in Acute Mesenteric Ischemia

Purpose

Surgical exploration and bowel resection are frequently required for treating non-occlusive mesenteric ischemia. Intraoperative evaluation of intestinal perfusion is subjective and challenging. In this feasibility study, ICG fluorescence angiography was performed in order to evaluate intestinal perfusion in patients with acute mesenteric ischemia.

Methods

This is a retrospective analysis of 52 patients who were operated for acute mesenteric ischemia using ICG fluorescence angiography. Patients with occlusive disease requiring recanalization were excluded. The SPY and PinPoint imaging systems were used for open and laparoscopic surgery, respectively. Intraoperative macroscopic assessment of perfusion was compared with the ICG angiography results.

Results

Surgical exploration was performed for ischemia of the colon (n?=?12), the small bowel (n?=?23), or both (n?=?16). One patient had ischemia of the esophagus and stomach. All patients had a preoperative CT angiography to rule out stenosis or occlusion of the mesenteric vessels. In 18 cases (34.6%), ICG fluorescence angiography provided information that was supplemental to macroscopic evaluation, but most patients did not survive the postoperative course. However, in six of those cases (11.5%), ICG angiography led to a major change in operative strategy resulting in a significant clinical benefit for those patients. For two cases, ICG fluorescence produced false negative results.

Discussion

ICG tissue angiography is feasible and technically reliable for evaluating intestinal perfusion in acute mesenteric ischemia and led to a significant clinical benefit in 11% of our patients. A relevant discrepancy between surgical visual assessment and fluorescence angiography was found in 35% of the cases, which may help to define resection margins more accurately and thus support surgical decision-making.