CAJ | 학술논문

目的探讨Na99mTcO4示踪显像(TTI)监测上肢周围血管术后远端动脉血供和静脉回流的临床价值.方法 36例上肢周围血管术后患者静脉注射Na99mTcO4740 MBq 5 min后行术肢(指)体单光子发射计算机断层成像术静态显像,计算并分析术肢(指)远端和正常肢(指)对应部分的放射性摄取比值(T/NT).根据术肢(指)放射性聚集程度将显像结果分为0、Ⅰ、Ⅱ、Ⅲ四级,分别为A、B、C、D四组.A、B组给予局部热敷和解痉治疗,C组常规治疗,D组抬高患肢和减压处理.30 min后再次TTI,为0、Ⅲ级患者施行探查术.结果 A、B、C、D组分别有11、7、13、5例患者,其T/NT分别为(0.142 ±0.058)、(0.384±0.046)、(0.794±0.072)、(1.12 ±0.076),各组间差异均有统计学意义(t=2.33a、4.33b、6.90b、2.59a、5.73b、2.12a,aP＜0.05,bP＜0.01)；再次TTI显示:A组0级7例(手术证实为吻合动脉血栓形成),Ⅰ级4例；B组Ⅰ级3例,Ⅱ级4例；C组13例全为Ⅱ级；D组Ⅱ级4例,Ⅲ级1例(手术证实为静脉血栓).结论 TTI能经济、简便、无创地监测周围血管术后远端动脉血供和静脉回流,具有重要的临床价值.
목적 탐토Na99mTcO4시종현상(TTI)감측상지주위혈관술후원단동맥혈공화정맥회류적림상개치.방법 36례상지주위혈관술후환자정맥주사Na99mTcO4740 MBq 5 min후행술지(지)체단광자발사계산궤단층성상술정태현상,계산병분석술지(지)원단화정상지(지)대응부분적방사성섭취비치(T/NT).근거술지(지)방사성취집정도장현상결과분위0、Ⅰ、Ⅱ、Ⅲ사급,분별위A、B、C、D사조.A、B조급여국부열부화해경치료,C조상규치료,D조태고환지화감압처리.30 min후재차TTI,위0、Ⅲ급환자시행탐사술.결과 A、B、C、D조분별유11、7、13、5례환자,기T/NT분별위(0.142 ±0.058)、(0.384±0.046)、(0.794±0.072)、(1.12 ±0.076),각조간차이균유통계학의의(t=2.33a、4.33b、6.90b、2.59a、5.73b、2.12a,aP＜0.05,bP＜0.01)；재차TTI현시:A조0급7례(수술증실위문합동맥혈전형성),Ⅰ급4례；B조Ⅰ급3례,Ⅱ급4례；C조13례전위Ⅱ급；D조Ⅱ급4례,Ⅲ급1례(수술증실위정맥혈전).결론 TTI능경제、간편、무창지감측주위혈관술후원단동맥혈공화정맥회류,구유중요적림상개치.
Objective To evaluate the clinical value of the upper extremital artery supply and vein running back in the patients after peripheral vascular surgery by Na99mTcO4 trace imaging(TTI).Methods SPECT static imaging was performed on 36 patients after peripheral vascular surgery in vein injecting Na99mTcO4 740 MBq 5min.The radioactivity uptake of operated limb(finger)/normal limb(finger) ratio(T/NT) was analyzed using region of interest analysis.0,Ⅰ,Ⅱand Ⅲ scales were classified according to their radionuclide distribution and T/NT,were divided into A,B,C and D group,respectively.Localy warming and anticontrctive therapy were only given in A and B group for 30min,routine therapy in C group,and raising operated limb (finger) and reductive pressure treatment in D group.Then,exploratory surgery was performed on 0 scales and Ⅲ scales of TTI again.Results A,B,C and D group were 11,7,13 and 5 patients,their T/NT was (0.142 ± 0.058),(0.384 ± 0.046),(0.794 ± 0.072) and (1.12 ±0.076),respectvely,and there were significant differences among the groups(t =2.33a,4.33b,6.90b,2.59a,5.73b,2.12a,aP ＜ 0.05,b P ＜ 0.O1) ;TTI again showed:there were 7 cases of 0 scales (arterial thrombosis was confirmed by exploratory surgery) and 4 cases of Ⅰ scales in A group,3 cases of Ⅰ scales and 4 cases of Ⅱ scales in B group,all 13 cases of Ⅱ scales in C group,4 cases of Ⅱ scales and 1 case of Ⅲ scales(vein thrombosis was confirmed by exploratory surgery) in D group.Conclusion TTI could play an important role in economical,simple and notraumatic diagnosing the extremital artery supply and vein running back in the patients after peripheral vascular surgery.