加速康复外科理念下近红外二区成像介导创伤修复重建手术的效果分析
Trauma repair and reconstruction surgery mediated by near-infrared-Ⅱ imaging:application of enhanced recovery after surgery principles
杨璠 1吴亦凡 1喻译锋 2王正 1胡婧 1徐嫚娟 1简超 1漆白文 1喻爱喜 1张栋1
作者信息
- 1. 武汉大学中南医院创伤与显微骨科,武汉 430071
- 2. 武汉大学人民医院骨科,武汉 430060
- 折叠
摘要
目的 探讨加速康复外科(ERAS)理念下近红外二区(NIR-Ⅱ)成像介导创伤修复重建手术的效果.方法 回顾性分析2021年5月至2021年12月武汉大学中南医院创伤与显微骨科在ERAS理念下应用NIR-Ⅱ成像介导创伤修复重建手术的38例患者资料.男22例,女16例;年龄为(50.3±2.7)岁.NIR-Ⅱ成像用于血管吻合术后通畅性判断14例,介导皮瓣切取与灌注监测13例,断指再植术后动/静脉血供评价11例.记录患者术后2、7、14 d疼痛视觉模拟评分(VAS),住院时间、患者满意度[采用中国医院住院患者体验和满意监测量表(CHPESM)]、肢体功能恢复情况(采用Likert5级评分法)及术后并发症发生情况.结果 所有患者术后获14 d以上随访,手术均成功,修复重建部位肢体或皮瓣存活,基本恢复正常形态和功能.术后2、7、14 d所有患者VAS评分分别为(2.1±0.6)分、(1.6±0.6)分、(0.8±0.4)分,住院时间为(9.8±3.4)d,患者满意度＞95％.末次随访时肢体功能恢复情况则采用Likert5级评分法:无僵硬12例,轻度僵硬8例,僵硬稍严重11例,中度到重度僵硬3例,严重僵硬2例,完全僵硬2例.所有患者均无手术相关并发症发生.结论 在ERAS理念下应用NIR-Ⅱ成像技术介导创伤修复重建手术,可有效缓解患者疼痛、提升满意度、缩短住院时间、加速患者康复.
Abstract
Objective To evaluate trauma repair and reconstruction surgery mediated by near-infrared-Ⅱ(NIR-Ⅱ)imaging in practice of enhanced recovery after surgery(ERAS)principles.Methods A retrospective study was conducted to analyze the data of 38 patients who had undergone trauma repair and reconstruction surgery mediated by near-infrared-Ⅱ(NIR-Ⅱ)imaging in practice of ERAS principles at Department of Orthopedic Trau-ma and Microsurgery,Zhongnan Hospital from May 2021 to December 2021.There were 22 males and 16 females with an age of(50.3±2.7)years.To implement ERAS,NIR-Ⅱ imaging was used for patency evaluation after vascular anastomosis in 14 cases,for skin flap harvesting and perfusion monitoring in 13 cases,and for evaluation of arterial/venous blood supply after finger replantation in 11 cases.Visual analogue scale(VAS)pain scores at 2,7 and 14 days after surgery,length of hospital stay,patient satisfaction[by Chinese Hospital Patient Experience and Satisfaction Monitor(CHPESM)],limb function recovery(by Likert scale)and postoperative complications were recorded.Results All patients were followed up for more than 14 days.All surgeries succeeded.The reconstructed limbs or flaps survived to recover basically normal shape and function.The VAS scores for all patients were(2.1±0.6)points,(1.6±0.6)points and(0.8±0.4)points on postoperative 2,7 and 14 days,respectively.The length of hospital stay was(9.8±3.4)days,and the patient satisfaction was＞95％at discharge.As for the recovery of limb function at the last follow-up evaluated by the Likert 5-point scale,12 cases experienced no stiffness,8 ones mild stiffness,11 ones slightly severe stiffness,3 ones moderate to se-vere stiffness,2 ones severe stiffness,and 2 ones complete stiffness.Complications related to the surgery oc-curred in none of the patients.Conclusion In practice of ERAS principles,application of NIR-Ⅱ imaging in trauma repair and reconstruction surgery can effectively alleviate pain,improve satisfaction,reduce hospital stay,and accelerate functional recovery for the patients.
关键词
创伤和损伤/修复外科手术/谱学,近红外线/康复Key words
Wounds and injuries/Reconstructive surgical procedures/Spectroscopy,near-infrared/Rehabilitation引用本文复制引用
出版年
2024
NETL
NSTL
万方数据