微循环检测技术及其在急诊危重医学中的应用进展
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摘要
<正>在急诊危重医学研究领域,人体微循环(microcirculation)状态对疾病的发生、发展、预后有着重要的意义,而微循环检测、动态监测和评估日益受到临床工作者的重视,将成为传统血液动力学监测后又一项病情评估指标。微循环是指微动脉和微静脉之间血液循环,是机体进行物质和气体交换的场所,对维持组织细胞新陈代谢和内环境稳态起重要作用。机体各器官、组织结构和功能不同,微循环组成也不同,相应的微循环检测技术也不尽相同,随着科技发展,新技术也不断涌现。这些新技术将
In recent years,more researches have been focused on the microcirculation,and the role of microcirculation in critical care medicine has been recognized gradually.Meantime,the advanced technologies of detecting microcirculation are also improving dramatically.The present article reviews the progressive technologies in microcirculation detection and its application in the field of emergency and critical care medicine.
In recent years,more researches have been focused on the microcirculation,and the role of microcirculation in critical care medicine has been recognized gradually.Meantime,the advanced technologies of detecting microcirculation are also improving dramatically.The present article reviews the progressive technologies in microcirculation detection and its application in the field of emergency and critical care medicine.
引文
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[14]Bosch A,Scheppach JB,Harazny JM,et al.Retinal capillary and arteriolar changes in patients with chronic kidney disease[J].Microvasc Res,2018,118,121-127.
[15]金慧,李志鹏,郭晓华,等.重症中暑大鼠微血管血流改变及抗氧化剂的保护作用[J].临床急诊杂志,2017,18(5):321-327.
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[17]龙春艳,何晶玲,魏芳,等.超声造影定量评估失血性休克肝微循环灌注的实验研究[J].中国医学影像学杂志,2017,25(5):325-328.
[18]Hildebrandt W,Schwarzbach H,Pardun A,et al.Agerelated differences in skeletal muscle microvascular response to exercise as detected by contrast-enhanced ultrasound(CEUS)[J].PLoS One,2017,12(3):e0172771.
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[21]Zhang X,Qian X,Tao C,et al.In Vivo Imaging of Microvasculature during Anesthesia with High-Resolution Photoacoustic Microscopy[J].Ultrasound Med Biol,2018,44(5):1110-1118.
[22]Tsai MT,Chen Y,Lee CY,et al.Noninvasive structural and microvascular anatomy of oral mucosae using handheld optical coherence tomography[J].Biomed Opt Express,2017,8(11):5001-5012.
[23]Qin W,Roberts MA,Qi X,et al.Depth-resolved 3Dvisualization of coronary microvasculature with optical microangiography[J].Phys Med Biol,2016,61(21):7536-7550.
[24]Humeau-Heurtier A,MahéG,Abraham P.Microvascular blood flow monitoring with laser speckle contrast imaging using the generalized differences algorithm[J].Microvascular Research,2015,98:54-61.
[25]Barcelos A,Tibirica E,Lamas C.Evaluation of microvascular endothelial function and capillary density in patients with infective endocarditis using laser speckle contrast imaging and video-capillaroscopy[J].Microvasc Res,2018,118:61-68.
[26]van Zijderveld R,Ince C,Schlingemann RO.Orthogonal polarization spectral imaging of conjunctival microcirculation[J].Graefes Arch Clin Exp Ophthalmol,2014,252(5):773-779.
[27]Treu C,de Souza MDGC,Lupi O,et al.Structural and functional changes in the microcirculation of lepromatous leprosy patients-Observation using orthogonal polarization spectral imaging and laser Doppler flowmetry iontophoresis[J].PLoS One,2017,12(4):e0175743.
[28]高飞,傅小云,钱明江,等.侧流暗场成像技术观察内毒素休克兔小肠绒毛与舌下微循环改变[J].中国病理生理杂志,2017,33(4):764-768.
[29]Yin L,Yang Z,Yu H,et al.Changes in sublingual microcirculation is closely related with that of bulbar conjunctival microcirculation in a rat model of cardiac arrest[J].Shock,2016,45(4):428-433.
[30]Qian J,Yang Z,Cahoon J,et al.Post-resuscitation intestinal microcirculation:its relationship with sublingual microcirculation and the severity of post-resuscitation syndrome[J].Resuscitation,2014,85(6):833-839.
[31]van Elteren HA,Ince C,Tibboel D,et al.Cutaneous microcirculation in preterm neonates:comparison between sidestream dark field(SDF)and incident dark field(IDF)imaging[J].J Clin Monit Comput,2015,29(5):543-548.
[32]Akin S,Dos Reis Miranda D,Caliskan K,et al.Functional evaluation of sublingual microcirculation indicates successful weaning from VA-ECMO in cardiogenic shock[J].Crit Care,2017,21(1):265.
[33]王龙廷,郭凯,周荣斌.脓毒症液体复苏终指标研究与限制性液体管理[J].临床急诊杂志,2015,16(2):160-164.
[34]Cecconi M,De Backer D,Antonelli M,et al.Consensus on circulatory shock and hemodynamic monitoring.Task force of the European Society of Intensive Care Medicine[J].Intensive Care Med,2014,40(12):1795-1815.
[2]Rovas A,Lukasz AH,Vink H,et al.Bedside analysis of the sublingual microvascular glycocalyx in the emergency room and intensive care unit-the GlycoNurse study[J].Scand J Trauma Resusc Emerg Med,2018,26(1):16.
[3]Gilbert-Kawai E,Coppel J,Bountziouka V,et al.Acomparison of the quality of image acquisition between the incident dark field and sidestream dark field video-microscopes[J].BMC Med Imaging,2016,16:10.
[4]Massey MJ,Shapiro N.A guide to human in vivo microcirculatory flow image analysis[J].Crit Care,2016,20:35.
[5]Ocak I,Kara A,Ince C.Monitoring microcirculation[J].Best Pract Res Clin Anaesthesiol,2016,30(4):407-418.
[6]De Backer D,Hollenberg S,Boerma C,et al.How to evaluate the microcirculation:report of a round table conference[J].Crit Care.2007,11(5):R101.
[7]Ellis CG,Jagger J,Sharpe M.The microcirculation as a functional system[J].Crit Care,2005,9Suppl 4:S3-8.
[8]Trzeciak S,McCoy JV,Phillip Dellinger R,et al.Early increases in microcirculatory perfusion during protocol-directed resuscitation are associated with reduced multi-organ failure at 24hin patients with sepsis[J].Intensive Care Med,2008,34(12):2210-2217.
[9]Ince C,Boerma EC,Cecconi M,et al.Second consensus on the assessment of sublingual microcirculation in critically ill patients:results from a task force of the European Society of Intensive Care Medicine[J].Intensive Care Med,2018,44(3):281-299.
[10]Rhodes A,Evans LE,Alhazzani W,et al.Surviving sepsis campaign:international guidelines for management of sepsis and septic shock:2016[J].Intensive Care Med,2017,43(3):304-377.
[11]De Backer D,Creteur J,Preiser JC,et al.Microvascular blood flow is altered in patients with sepsis[J].Am JRespir Crit Care Med,2002,166(1):98-104.
[12]Moo EK,Sibole SC,Han SK,et al.Three-dimensional micro-scale strainmapping in living biological soft tissues[J].Acta Biomater,2018,70:260-269.
[13]Diana M,Dallemagne B,Chung H,Probe-based confocal laser endomicroscopy and fluorescence-based enhanced reality for real-time assessment of intestinal microcirculation in a porcine model of sigmoid ischemia[J].Surg Endosc,2014,28(11):3224-3233.
[14]Bosch A,Scheppach JB,Harazny JM,et al.Retinal capillary and arteriolar changes in patients with chronic kidney disease[J].Microvasc Res,2018,118,121-127.
[15]金慧,李志鹏,郭晓华,等.重症中暑大鼠微血管血流改变及抗氧化剂的保护作用[J].临床急诊杂志,2017,18(5):321-327.
[16]Mastantuono T,Starita N,Battiloro L,et al.Laser speckle imaging of rat pial microvasculature during hypoperfusion-reperfusion damage[J].Front Cell Neurosci,2017,11:298.
[17]龙春艳,何晶玲,魏芳,等.超声造影定量评估失血性休克肝微循环灌注的实验研究[J].中国医学影像学杂志,2017,25(5):325-328.
[18]Hildebrandt W,Schwarzbach H,Pardun A,et al.Agerelated differences in skeletal muscle microvascular response to exercise as detected by contrast-enhanced ultrasound(CEUS)[J].PLoS One,2017,12(3):e0172771.
[19]Yao J,Wang L,Yang JM,et al.High-speed label-free functional photoacoustic microscopy of mouse brain in action[J].Nat Methods,2015,12(5):407-410.
[20]Cai,Li Z,Li Y,et al.Photoacoustic microscopy in vivo using synthetic-aperture focusing technique combined with three-dimensional deconvolution[J].Opt Express,2017,25(2):1421-1434.
[21]Zhang X,Qian X,Tao C,et al.In Vivo Imaging of Microvasculature during Anesthesia with High-Resolution Photoacoustic Microscopy[J].Ultrasound Med Biol,2018,44(5):1110-1118.
[22]Tsai MT,Chen Y,Lee CY,et al.Noninvasive structural and microvascular anatomy of oral mucosae using handheld optical coherence tomography[J].Biomed Opt Express,2017,8(11):5001-5012.
[23]Qin W,Roberts MA,Qi X,et al.Depth-resolved 3Dvisualization of coronary microvasculature with optical microangiography[J].Phys Med Biol,2016,61(21):7536-7550.
[24]Humeau-Heurtier A,MahéG,Abraham P.Microvascular blood flow monitoring with laser speckle contrast imaging using the generalized differences algorithm[J].Microvascular Research,2015,98:54-61.
[25]Barcelos A,Tibirica E,Lamas C.Evaluation of microvascular endothelial function and capillary density in patients with infective endocarditis using laser speckle contrast imaging and video-capillaroscopy[J].Microvasc Res,2018,118:61-68.
[26]van Zijderveld R,Ince C,Schlingemann RO.Orthogonal polarization spectral imaging of conjunctival microcirculation[J].Graefes Arch Clin Exp Ophthalmol,2014,252(5):773-779.
[27]Treu C,de Souza MDGC,Lupi O,et al.Structural and functional changes in the microcirculation of lepromatous leprosy patients-Observation using orthogonal polarization spectral imaging and laser Doppler flowmetry iontophoresis[J].PLoS One,2017,12(4):e0175743.
[28]高飞,傅小云,钱明江,等.侧流暗场成像技术观察内毒素休克兔小肠绒毛与舌下微循环改变[J].中国病理生理杂志,2017,33(4):764-768.
[29]Yin L,Yang Z,Yu H,et al.Changes in sublingual microcirculation is closely related with that of bulbar conjunctival microcirculation in a rat model of cardiac arrest[J].Shock,2016,45(4):428-433.
[30]Qian J,Yang Z,Cahoon J,et al.Post-resuscitation intestinal microcirculation:its relationship with sublingual microcirculation and the severity of post-resuscitation syndrome[J].Resuscitation,2014,85(6):833-839.
[31]van Elteren HA,Ince C,Tibboel D,et al.Cutaneous microcirculation in preterm neonates:comparison between sidestream dark field(SDF)and incident dark field(IDF)imaging[J].J Clin Monit Comput,2015,29(5):543-548.
[32]Akin S,Dos Reis Miranda D,Caliskan K,et al.Functional evaluation of sublingual microcirculation indicates successful weaning from VA-ECMO in cardiogenic shock[J].Crit Care,2017,21(1):265.
[33]王龙廷,郭凯,周荣斌.脓毒症液体复苏终指标研究与限制性液体管理[J].临床急诊杂志,2015,16(2):160-164.
[34]Cecconi M,De Backer D,Antonelli M,et al.Consensus on circulatory shock and hemodynamic monitoring.Task force of the European Society of Intensive Care Medicine[J].Intensive Care Med,2014,40(12):1795-1815.