探讨高频彩色多普勒超声联合红外线热成像技术在游离股前外侧穿支分叶皮瓣术前导航中的作用。

2015年1月至2019年12月37例在浙江大学医学院附属金华医院行游离股前外侧穿支分叶皮瓣移植修复术的患者，术前应用高频彩色多普勒超声和红外热像仪检查，参照术中探查所见，比较高频彩色多普勒超声、红外线热成像技术以及两者联合在限定范围内对有效穿支、最具活力穿支检出的准确率，以及两者联合设计的优势共干穿支皮瓣与术中采用皮瓣的符合率。采用χ²检验比较不同方法有效穿支检出率的差异。

37例患者术中探查有效穿支99支，高频彩色多普勒超声、红外线热成像技术以及两者联合分别检出91支（91.9%）、90支（90.9%）、98支（99.0%），高频彩色多普勒超声对股前外侧有效穿支的检出准确率高于红外线热成像技术，但差异无统计学意义（P＞0.05）；两者联合检出准确率高于单一检测技术，差异具有统计学意义（χ²=4.193，P=0.017；χ²=5.164，P=0.009）。对最具活力穿支的检出，红外线热成像技术失败1例，准确率为97.3%（36/37），高频彩色多普勒超声准确率为100%。按两者联合设计的分叶皮瓣均在术中被采用。

高频彩色多普勒超声联合红外线热成像技术能提高股前外侧穿支血管定位的准确率，为分叶皮瓣的设计提供可靠证据。

To assess the clinical value of high frequency color Doppler ultrasound combined with infrared thermography in the preoperative navigation of lobulated anterolateral thigh perforator flap transfer.

Thirty-seven patients who underwent free lobulated anterolateral thigh perforator flap transfer at Jinhua Hospital of Zhejiang University School of Medicine from January 2015 to December 2019 were examined by high-frequency color Doppler ultrasound and infrared thermography before operation. According to the intra-operative findings, the accuracy of high-frequency color Doppler ultrasound, infrared thermography, and their combination in detecting the effective perforators and the most active perforators was compared. The concordance rate between the flap designed by the use of both of the methods combined and the flap used in the surgery was assessed.

There were 99 effective perforators detected in 37 patients during operation. And 91 (91.9%), 90 (90.9%), and 98 (99.0%) perforators were detected by high-frequency color Doppler ultrasound, infrared thermography, and the two combined, respectively. High-frequency color Doppler ultrasound was more accurate than infrared thermography in detecting the effective anterolateral thigh perforators, but the difference was not statistically significant (P＞0.05). The two methods combined were more effectively than either of them alone, and the differences were statistically significant (χ²=4.193, P=0.017; χ²=5.164, P=0.009). For the detection of the most active perforators, infrared thermography failed to detect one case, with an accuracy rate of 97.3%. The accuracy rate of high-frequency color Doppler ultrasound was 100%. The lobulated flap designed based on the combination of the two methods was used in the surgery.

High frequency color ultrasound combined with infrared thermography can improve the detection of anterolateral thigh perforator vessels to provide a basis for the design of lobulated flaps.