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目的 探讨断指再植术后早期 (<48h)动态99Tcm RBC血池显像 (BPI)的临床价值。方法 30例断指再植患者于术后 48h内进行 5次BPI,计算并对比分析再植指和正常指的放射性比值 (T/NT) ,根据再植指放射性聚集程度将显像结果分为 0、Ⅰ、Ⅱ级。结果 再植指通过 4次高压氧(HBO)治疗后的T/NT(0 6 2 4± 0 310 )明显高于治疗前 (0 413± 0 2 74,t=2 79,P <0 0 1) ,4次治疗后的T/NT变化情况可作为终止HBO治疗的指征 ;治疗前显像为 0、Ⅰ、Ⅱ级的T/NT分别为 0 149±0 0 6 3、0 46 3± 0 0 5 0、0 840± 0 2 0 2 (t=11 87、9 30、5 77,P <0 0 1) ,血管危象发生率分别为 10 0 %、2 0 %、0 (χ2 分别为 2 8 8、2 0 0 ,P <0 0 1) ;48h时显像为 0、Ⅰ、Ⅱ级表现的再植指需再次手术和 (或 )坏死发生率分别为 10 0 %、8 3%、0 (χ2 分别为 11 7、18 0 ,P <0 0 1)。结论 BPI对断指再植术后早期动态监测疗效、预测血管危象发生和预后及进一步选择治疗方案均有重要的临床价值
Objective To investigate the clinical value of dynamic 99Tcm RBC blood pool imaging (BPI) in the early stage after replantation of severed finger (<48h). Methods Thirty patients with replantation of severed finger were subjected to BPI five times within 48 hours after surgery. The ratio of T / NT to replantation index and normal index was calculated and compared. The imaging results were divided into 0, Ⅰ, Ⅱ grade. Results Replantation showed that T / NT (0 624 ± 0 310) after 4 HBO treatments was significantly higher than before treatment (0 413 ± 0 2 74, t = 2 79, P 0 01 ), And the changes of T / NT after 4 treatments could be used as an indication to terminate the treatment of HBO. The imaging before treatment was 0, the T / NT of grade Ⅰ and Ⅱ were 0 149 ± 0 0 6 3 and 0 46 3 ± The incidences of vascular crisis were 100%, 20%, 0 (χ2, respectively, 0%, 0%, 0% 2,88,2 0 0, P 0 01). At 48 hours, the imaging showed 0. The replanted fingers of grade Ⅰ and Ⅱ required 10% of reoperation and / or necrosis, respectively %, 0 (χ2 = 11 7,18 0, P <0 0 1, respectively). Conclusion BPI has important clinical value in early dynamic monitoring after replantation of replantation, in predicting the occurrence and prognosis of vascular crisis and further treatment options