首页|聚醚醚酮定位标志物联合混合现实技术在股前外侧穿支皮瓣血管定位中的应用研究

聚醚醚酮定位标志物联合混合现实技术在股前外侧穿支皮瓣血管定位中的应用研究

扫码查看
目的 探讨聚醚醚酮(poly ether ether ketone,PEEK)定位标志物联合混合现实技术应用于股前外侧穿支皮瓣血管定位中的效果.方法 回顾分析2022年1月-2023年6月,采用股前外穿支皮瓣修复40例口腔癌切除后组织缺损患者临床资料.根据术中股前外侧穿支皮瓣定位方式不同,随机分为PEEK组[采用PEEK定位标志物联合CT血管造影(CT angiography,CTA)数据的混合现实技术定位]和彩超组(采用彩色超声多普勒引导定位),每组20例.两组患者性别、年龄、病因、病程等基线资料比较差异均无统计学意义(P>0.05).记录两组感兴趣区域识别到的穿支血管数量,并与术中实际探查到的数量进行比较,计算穿支血管识别成功率;测量两组定位的穿支血管穿出点与实际穿出点之间的距离;记录制取皮瓣的手术时间.结果 PEEK组共识别32个穿支血管,术中探查发现34个,识别成功率为94.1%(32/34);彩超组识别穿支血管29个,术中探查发现33个,识别成功率为87.8%(29/33);两组穿支血管识别成功率比较差异有统计学意义(P<0.05).PEEK组定位的穿支血管穿出点与实际穿出点距离以及手术时间均短于彩超组(P<0.05).两组患者均获随访,随访时间6~30个月,中位时间17个月;两组随访时间比较差异无统计学意义(P>0.05).PEEK组1例皮瓣远端边缘坏死,经修剪换药后延迟愈合;彩超组1例皮瓣术后7 d坏死,清除坏死皮瓣后选择胸大肌皮瓣修复;其余患者皮瓣均成活,切口 Ⅰ期愈合.PEEK组发生供区感染1例,经抗炎处理后愈合.两组修复颌面部外形好,皮瓣无明显臃肿,患者对修复效果较满意.结论 相较于传统彩色超声多普勒定位,PEEK定位标志物结合CTA数据的混合现实技术定位股前外侧穿支皮瓣血管的识别成功率和定位精度更高,制取皮瓣时间短,具有较高临床应用价值.
Application of poly ether ether ketone localization marker combined with mixed reality technology in vessel localization of anterolateral thigh perforator flap
Objective To compare the effectiveness of poly ether ether ketone(PEEK)localization marker combined with mixed reality technology versus color doppler ultrasound guidance for the vessel localization of anterolateral thigh perforator flap.Methods A retrospective analysis was conducted on 40 patients with tissue defects after oral cancer resection who underwent repair using the anterolateral thigh perforator flap between January 2022 and June 2023.According to the different intraoperative positioning methods of the anterolateral thigh perforator flap,they were randomly divided into PEEK group[using PEEK localization marker combined with mixed reality technology based on CT angiography(CTA)data]and color ultrasound group(using color ultrasound guidance),with 20 cases in each group.There was no significant difference in gender,age,etiology,and disease duration between the two groups(P>0.05).The number of perforator vessels identified in the two groups of regions of interest was recorded,and compared them with the intraoperative actually detected number to calculate the success identifying rate of perforator vessels;the distance between the perforating point and the actual puncture point was measured,the operation time of the two groups of flaps was recorded.Results In the PEEK group,32 perforator vessels were identified,34 were detected by intraoperative exploration,and the success identifying rate was 94.1%(32/34);in the color ultrasound group,29 perforator vessels were identified,33 were detected by intraoperative exploration,and the success identifying rate was 87.8%(29/33);there was a significant difference in the success identifying rate between the two groups(P<0.05).The distance between the perforating point and the actual puncture point and the operation time in PEEK group were significantly shorter than those in color ultrasound group(P<0.05).Patients in both groups were followed up 6-30 months,with a median of 17 months;there was no significant difference in follow-up time between the two groups(P>0.05).In the PEEK group,there was 1 case of flap necrosis at the distal edge and delayed healing after trimming and dressing change.In the color ultrasound group,there was 1 case of flap necrosis at 7 days after operation and pectoralis major myocutaneous flap was selected for repair after removal of the necrotic flap.In the rest,the flap survived and the incision healed by first intention.Donor site infection occurred in 1 case in PEEK group and healed after anti-inflammatory treatment.The maxillofacial appearance of the two groups was good,the flap was not obviously bloated,and the patients were satisfied with the repair effect.Conclusion Compared with the traditional color ultrasound guidance,the PEEK localization marker combined with mixed reality technology based on CTA data in vessel localization of anterolateral thigh perforator flap has higher success identifying rate and positioning accuracy,and the flap production time is shorter,which has high clinical application value.

Poly ether ether ketonemixed reality technologycolor ultrasound guidanceanterolateral thigh perforator flapperforator vessel localization

徐庆、吴双江、吴剑、周莲、李真华、何云刚、刘一秀

展开 >

成都大学附属医院口腔科(成都 610081)

西南医科大学附属口腔医院口腔颌面外科口腔颌面修复重建和再生泸州市重点实验室(四川泸州 646000)

重庆大学附属肿瘤医院头颈肿瘤科肿瘤转移与个体化诊治转化研究重庆市重点实验室(重庆 400030)

聚醚醚酮 混合现实技术 彩色超声多普勒引导 股前外侧穿支皮瓣 穿支血管定位

2024

中国修复重建外科杂志
中国康复医学会,四川大学华西医院

中国修复重建外科杂志

CSTPCD北大核心
影响因子:1.239
ISSN:1002-1892
年,卷(期):2024.38(12)