PDF(Pubmed)
Abstract：
(1) Background: Oncological demolitive-reconstructive surgeries in the head and neck region cause significant stress on patients\' biohumoural, cardiac, and vascular systems, leading to disturbances in macrocirculatory and microcirculatory parameters. Traditional monitoring addresses the symptoms, but not the underlying cause. Microcirculatory assessments complement macrocirculatory monitoring, and bladder-catheter-based technology offers a better representation of central microcirculation. Flap reconstruction surgeries involve demolitive and reconstructive phases, requiring optimal tissue perfusion. The literature lacks a consensus on macro-microcirculation coupling, and there is no agreement on the use of vasopressors during head and neck surgeries. Evidence-based guidelines are lacking, resulting in variations in vasopressor administration. (2) Methods: This is a 12-month observational, prospective study conducted in a single center. It aims to evaluate the impact of macro-microcirculation coupling on clinical complications in head and neck surgery. All consecutive patients undergoing oncologic surgery requiring flap reconstruction and meeting the inclusion criteria will be enrolled. The study will utilize standard hemodynamic monitoring and bladder catheterization for measuring urine output and temperature. (3) Conclusions: The study aims to evaluate the coupling of macro- and microcirculation in head and neck surgeries, assess hemodynamic parameters and microcirculatory changes, and investigate their association with postoperative complications. The results can enhance patient care and surgical outcomes.
摘要：
（1）背景：头颈部肿瘤的拆除重建手术对患者的生物体液造成显著的压力，心脏,和血管系统，导致大循环和微循环参数的干扰。传统的监测解决了症状，但不是根本原因。微循环评估补充了大循环监测，基于膀胱导管的技术可以更好地代表中央微循环。皮瓣重建手术包括拆除和重建阶段，需要最佳的组织灌注。文献对宏观微循环耦合缺乏共识，在头颈部手术中使用血管加压药没有达成一致。缺乏循证指南，导致血管升压药给药的变化。(2)方法：这是一个为期12个月的观察，在单中心进行的前瞻性研究。目的评估宏观-微循环耦合对头颈部手术临床并发症的影响。所有连续接受需要皮瓣重建并符合纳入标准的肿瘤手术患者将被纳入。该研究将利用标准的血液动力学监测和膀胱导管插入术来测量尿量和温度。(3)结论:本研究旨在评估头颈部手术中大、微循环的耦合,评估血液动力学参数和微循环变化，并探讨其与术后并发症的关系。结果可以提高患者护理和手术效果。
