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題名 | Temperature Changes in Ipsilateral Palmar Skin after Radial Forearm Flap Harvest--A Prospective Study by Thermography=利用紅外線溫色圖來定量分析橈側前臂皮瓣手術對手掌血液循環的影響--前瞻性臨床研究 |
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作者 | 林聖哲; 林啟禎; 邱浩遠; 鄭國順; Lin, Sheng-che; Lin, Chii-jeng; Chiu, Haw-yen; Cheng, Kuo-sheng; |
期刊 | 中華民國重建整形外科醫學會雜誌 |
出版日期 | 19991200 |
卷期 | 8:4 1999.12[民88.12] |
頁次 | 頁245-252 |
分類號 | 416.41 |
語文 | eng |
關鍵詞 | 紅外線溫色圖; 前臂皮瓣手術; 手掌血液循環; Radial forearm flap; Infra-red thermography; Temperature change on palm; |
中文摘要 | 橈側前臂皮瓣手術被Dr Yang (1951), Dr song (1952)和 Dr Soutar (1953)發表後因為其皮瓣薄,可塑性強,血管彎異性小,管徑大又長,故廣為世界各重建顯微外科醫師使用,但是每一項手術都有其限制及併發症。如橈側前臂皮瓣手術後會造成植皮存活不良(尤其在肌腱外露處),上肢關節活動不良,抓力及握力減少,手腫脹,感覺異常,遇冷變紺,甚至橈骨骨折。而對於橈側動脈犧牲掉後所造成的手掌血液循環彎化則很少著墨,只散見於零星的病例報告。有鑑於此,我們利用紅外線溫色圖來前瞻性的定量分析15名患者橈側前臂皮瓣手術對手掌循環的影響。左手掌(手術部位)的平均溫度在術前為31.493℃,術後兩周為31.880℃ ,術後一個月為31.513℃以及術後一年為31.440℃,在同一時段的右手掌(非手術部位)平均溫度為31.447℃, 31.967℃, 31.473℃以及31.407℃,利用多重測量的變異數分析(repeated-measures ANOVA)發現術後兩周的手掌溫度比術前的確有統計上意義的增高,隨後漸減(P<0.001),利用Tukey HSD 事後檢定術後兩周的華掌平均溫度都比其他三個時段的手掌平均溫度為高(全部P<0.05),但如以左右手掌的溫度差(△:L-R)來比較時則無統計學上的差異(P=0.3532),因此以血液循環的變化而言,橈側前臂皮瓣手術雖然損傷了橈側動脈,但是對於長期性溫度改變而言並無影響,因此整形外科醫師可以放心使用於臨床重建手術中。 |
英文摘要 | The temperature changes of both palms were prospectively evaluated by infrared thermography in 15 patients undergoing radial forearm flap surgery at the National Cheng-Kung University Hospital. All patients were hospitalized for at least 2 weeks. And the temperature changes of both palms were measured preoperatively, on 2 weeks, 1 month and 1 year postoperatively. The average temperature of left palm were 31.493, 31.880, 31.513 and 31.440℃ for these four time points. The corresponding values of right palm were 31.447, 31.967, 31.473 and 31.407℃ respectively. At 2 weeks after surgery, the palmar temperature for both hands were elevated and then decreased thereafter (P<0.0001). The Tukey HSD method showed significant differences in palmar temperature between 2 weeks postoperatively and other three time points in both palms (all P<0.005). However, the differences between the left and right palmar temperature (Δ:L-R) were not significant different (P=0.3532) at the four time points of observation. A tendency of decrease in difference of left to right palmar temperature was observed, though, at 2 weeks postoperatively. Recognition of these patterns might lead to better understanding of the temperature change of palms after radial forearm flap and the role of anticoagulant drugs. |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。