Blood supply monitoring method and device after skin flap transfer operation

Abstract

The invention discloses a blood supply monitoring method and device after a skin flap transfer operation, and belongs to the field of postoperative nursing observation. The method comprises the following steps: acquiring a plurality of first temperature values corresponding to a plurality of first point locations in a first area in a free flap transferred to a receiving area, and calculating to obtain a first temperature mean value T1; acquiring a plurality of second temperature values corresponding to a plurality of second point locations in a second area in the free flap transferred to the receiving area, and calculating to obtain a second temperature mean value T2; a plurality of third temperature values corresponding to a plurality of third point positions in a normal skin area near the free flap transferred to the receiving area are obtained, and a third temperature mean value T3 is obtained through calculation; and executing a preset alarm prompt strategy based on the relationship among the first temperature mean value T1, the second temperature mean value T2 and the third temperature mean value T3. According to the method, the consistency of evaluating the postoperative flap blood supply state can be improved, and the sensitivity of identifying blood supply disorder can be improved.

Description

Technical Field

[0001] The present invention relates to the technical field of postoperative nursing observation, and in particular to a method and device for monitoring blood flow after flap transfer surgery. Background Art

[0002] In the existing technology, blood circulation monitoring and data recording after flap transfer are generally performed by professional nursing staff, which is highly subjective and needs to be performed personally by professional nursing staff, resulting in large differences in monitoring and recording data among different professional nursing staff. In addition, the efficiency of monitoring and recording is limited, and monitoring and recording cannot be performed more frequently, resulting in the inability to detect corresponding signs of vascular crisis earlier, which becomes a challenge to postoperative recovery.

[0003] In this regard, in the related art, it is proposed to use some monitoring instruments to improve the automation of blood circulation monitoring and data recording after flap transfer. For example, a method for infrared remote monitoring of blood circulation of tissue flaps disclosed in Patent Document 1 sets multiple temperature data collection points on the tissue flap and obtains multiple groups of sample temperature values ​​in real time; sets multiple temperature data collection points on the normal skin near the tissue flap and obtains multiple groups of control temperature values ​​in real time; when the difference between the sample mean temperature and the control mean temperature exceeds the difference range, it indicates that the tissue flap may have blood circulation obstruction, and the host issues an alarm prompt. The above scheme determines the blood circulation status of the flap by comparing whether the difference between the sample mean temperature on the flap and the control mean temperature on the nearby normal skin exceeds the difference range. For example, when the difference is greater than 3°C, a vascular crisis alarm prompt is issued, which can effectively improve the monitoring efficiency, accuracy and reliability of tissue flap blood circulation.

[0004] However, the above scheme still has the following shortcomings:

[0005] 1. The collection points selected on the skin flap for different patients cannot be determined. When determining the collection points on the skin flap for different patients, the operator's subjective cognition is still the main factor in selecting the collection points, resulting in poor consistency in evaluating the blood supply status of the skin flap after surgery.

[0006] 2. When the temperature difference between the skin flap and the nearby normal skin is greater than the threshold, it indicates that the overall blood circulation disorder of the skin flap has become quite serious. The above method can only reflect that the blood circulation status of the skin flap has deteriorated to a considerable extent compared with the nearby normal skin, but cannot reflect the blood circulation status of the skin flap itself before the deterioration, resulting in the inability to detect signs of blood pressure disorders earlier.

[0007] Patent document 1, patent name, infrared remote monitoring method and monitor for tissue flap blood flow; publication number, CN113425267A; publication date, 2021-09-24. Summary of the invention

[0008] The object of the present invention is to solve at least one of the technical problems existing in the prior art, and to provide a method for monitoring blood circulation after flap transfer. For each patient, the positions of each collection point in the flap are clearly defined in advance, which can improve the consistency of evaluating the blood circulation status of the flap after surgery. Moreover, based on the temperature difference in different regions inside the flap, it can reflect the deterioration signs of the blood circulation status of the flap earlier and improve the sensitivity of identifying blood circulation disorders.

[0009] To achieve the above object of the invention, the present invention provides the following technical solutions:

[0010] In a first aspect, the present invention provides a method for monitoring blood circulation after flap transfer, the method comprising:

[0011] Obtaining a plurality of first temperature values corresponding to a plurality of first points in a first region of a free flap transferred to a recipient area, and calculating a first average temperature T1; wherein, the first region is a region corresponding to the target blood vessel running region on the surface of the free flap transferred to the recipient area; the target blood vessel is a blood vessel anastomosed with the blood supply vessel of the recipient area;

[0012] Obtaining a plurality of second temperature values corresponding to a plurality of second points in a second region of the free flap transferred to the recipient area, and calculating a second average temperature T2; wherein, the second region is other regions on the surface of the free flap transferred to the recipient area except the first region;

[0013] Obtaining a plurality of third temperature values corresponding to a plurality of third points in a normal skin area near the free flap transferred to the recipient area, and calculating a third average temperature T3;

[0014] Based on the relationship among the first average temperature T1, the second average temperature T2, and the third average temperature T3, implementing a preset alarm prompt strategy; wherein, the preset alarm prompt strategy includes: if T1 < T2 < T3 and T3 - (T1 + T2) / 2 < θ, then issuing a first-level alarm prompt for blood circulation disorder; if T3 - (T1 + T2) / 2 ≥ θ, then issuing a second-level alarm prompt for blood circulation disorder; if T1 > T3, or T2 > T3, then issuing an alarm prompt for infection and inflammation; θ is a preset temperature difference threshold.

[0015] As a further improvement, the method further comprises:

[0016] At each preset monitoring time node, using the infrared thermal imaging lens of an imaging device to take an infrared thermal image of the recipient area including the free flap and the nearby normal skin;

[0017] The obtaining of the plurality of first temperature values corresponding to the plurality of first points in the first region of the free flap transferred to the recipient area specifically includes:

[0018] Based on a preset first coordinate set, a plurality of first temperature values ​​corresponding to a plurality of first points in the first area are obtained from the infrared thermal image of the receiving area; wherein the coordinates in the first coordinate set are used to define the boundary of the first area;

[0019] The step of obtaining a plurality of second temperature values ​​corresponding to a plurality of second points in a second area of ​​the free flap transferred to the recipient area specifically includes:

[0020] Based on a preset first coordinate set and a second coordinate set, a plurality of second temperature values ​​corresponding to a plurality of second points in a second area are obtained from the infrared thermal image of the recipient area; wherein the coordinates in the second coordinate set are used to define the boundary of a free skin flap transferred to the recipient area;

[0021] The step of obtaining a plurality of third temperature values ​​corresponding to a plurality of third points in a normal skin area near the free flap transferred to the recipient area specifically includes:

[0022] Based on a preset second coordinate set, a plurality of third temperature values ​​corresponding to a plurality of third points in a normal skin area near the free flap transferred to the recipient area are obtained from the infrared thermal image of the recipient area.

[0023] As a further improvement, the imaging device is configured with a visible light lens and an infrared thermal imaging lens at the same time, and the first coordinate set and the second coordinate set are obtained through the following process:

[0024] When the skin flap is still located at the donor area and is in a pedicled skin flap state, and when the imaging device is in a first posture, a visible light lens is used to take a visible light image of the first donor area including the pedicled skin flap, and an infrared thermal imaging lens is used to take an infrared thermal image of the donor area including the pedicled skin flap;

[0025] Based on a first mapping relationship between the visible light lens and the infrared thermal imaging lens, determine the first supply area visible light image and the supply area infrared thermal image Figure 2 A second mapping relationship of the image coordinate system;

[0026] Determine the running area of ​​the target blood vessel in the infrared thermal image of the donor area based on the target high temperature area connected to the pedicle in the infrared thermal image of the donor area;

[0027] Determine the running area of ​​the target blood vessel in the visible light image of the first donor area based on the running area of ​​the target blood vessel in the infrared thermal image of the donor area and the second mapping relationship;

[0028] When the imaging device is in a first posture, a visible light lens is used to capture a second donor area visible light image including the pedicled skin flap and a plurality of marking points; wherein the plurality of marking points are drawn on the surface of the pedicled skin flap in an area corresponding to the running area of ​​the target blood vessel with reference to the first visible light image;

[0029] After the skin flap becomes a free skin flap transferred to the recipient area, and when the imaging device is in a second posture, a visible light image of the recipient area including the free skin flap, a plurality of marking points and nearby normal skin is captured by a visible light lens, and an infrared thermal imaging lens is used to capture an infrared thermal image of the recipient area including the free skin flap, a plurality of marking points and nearby normal skin;

[0030] Based on a plurality of point pairs formed by the plurality of marking points in the second donor area visible light image and the recipient area visible light image, a third mapping relationship between the image coordinate systems of the second donor area visible light image and the recipient area visible light image is obtained;

[0031] Based on the first mapping relationship, the second mapping relationship and the third mapping relationship, a set of coordinates corresponding to the contour of the running area of ​​the target blood vessel in the infrared thermal image of the donor area is converted to the coordinate system of the infrared thermal image of the recipient area, and the first coordinate set is constructed by the set of coordinates converted to the coordinate system of the infrared thermal image of the recipient area;

[0032] The second coordinate set is constructed based on a set of coordinates corresponding to the edge contour of the free skin flap transferred to the recipient area in the infrared thermal image of the recipient area.

[0033] As a further improvement, the point on the infrared thermal image of the supply area whose temperature difference with the pedicle does not exceed a preset second temperature difference threshold is defined as a high-temperature point, and all points in the high-temperature area are high-temperature points; the target high-temperature area connected to the pedicle means that there must be a high-temperature path in the path from any high-temperature point in the target high-temperature area to the pedicle; wherein, the high-temperature path means that all points on the path are high-temperature points.

[0034] As a further improvement, at each preset monitoring time node, when using the infrared thermal imaging lens of the imaging device to shoot to obtain the infrared thermal image of the affected area, a positioning auxiliary frame is displayed on the shooting interface, and the positioning auxiliary frame includes an inner frame and an outer frame, the outline of the inner frame is defined by the first coordinate set, and the outline of the outer frame is defined by the second coordinate set.

[0035] As a further improvement, when entering the shooting interface for the n+1th time at a preset monitoring time node, the current posture of the imaging device is identified based on the posture sensor. If it is identified that the current posture of the imaging device is different from the posture at the nth shooting, the posture guide control is displayed in the shooting interface; wherein the posture guide control is used to display in real time the difference between the current posture of the imaging device and the posture at the nth shooting, as well as the adjustment direction and amount of the difference.

[0036] As a further improvement, the method further includes:

[0037] If it is detected that from the monitoring result of the nmth time to the monitoring result of the nth time, in a total of (m+1) monitoring results, the first temperature mean corresponding to each monitoring result shows a decreasing or increasing trend and T1>T2 and T3-(T1+T2) / 2<θ, then the monitoring time node t_(n+1) of the n+1th time is adjusted to:

[0038] t_(n+1)=t_(n)+α*△t; wherein n and m are positive integers, and m<n; α is the correction coefficient, △t is the preset time interval between two adjacent monitoring time nodes; t_(n) is the nth monitoring time node, 1 / 3≤α≤3 / 4.

[0039] As a further improvement, the method further includes:

[0040] At each preset monitoring time point, using a visible light lens of an imaging device to capture a visible light image of the recipient area including the free skin flap and nearby normal skin;

[0041] Comparing the color of the free skin flap in the visible light image of the recipient area with preset skin color data in a database;

[0042] Based on the comparison results, the skin color score corresponding to the free flap is determined.

[0043] In a second aspect, the present invention provides a computer-readable storage medium, wherein the computer-readable storage medium stores computer-executable instructions, and the computer-executable instructions are used to enable a computer to execute the steps of the above method.

[0044] In a third aspect, the present invention provides a blood flow monitoring device after flap transfer surgery, comprising: a memory, a processor, and a computer program stored in the memory and executable on the processor, wherein the processor executes the steps of the above method when executing the program.

[0045] Beneficial effects:

[0046] In the prior art, such as Patent Document 1, a vascular crisis alarm (i.e., the second-level alarm prompt of the present invention) can only be issued when the temperature of the skin flap is 3 degrees Celsius lower than the temperature of the normal skin nearby. At this time, the degree of vascular obstruction may be relatively deep, and there is a problem of late intervention time. In the present invention, a first-level alarm prompt can be triggered before the second-level alarm prompt, and the signs of blood supply obstruction of the skin flap can be found earlier by comparing the temperature difference between the target blood vessel running area and the non-target blood vessel running area inside the skin flap. Because the temperature of the blood vessel running area is higher than the surrounding area, especially for free skin flaps, the target blood vessel is anastomosed with the blood supply blood vessel of the recipient area, and the temperature in the free skin flap is higher than other areas. If the temperature of the target blood vessel running area is lower than the temperature of other areas in the free skin flap, it means that the blood supply of the target blood vessel may be obstructed, and a first-level alarm prompt can be issued, prompting the doctor to further make more detailed blood supply observations on the skin flap at an earlier stage, such as capillary filling observations, so before the blood supply obstruction phenomenon corresponding to the second-level alarm prompt occurs, the present invention can find earlier signs of blood supply obstruction and improve the sensitivity of identifying blood supply obstruction. Furthermore, in the present embodiment, there is no need to follow Reference 1, in which the selection of collection points for different patients is mainly affected by the operator. In the present embodiment, the positions of each collection point in the flap are clearly defined in advance for each patient, which can improve the consistency of evaluating the blood supply status of the flap after surgery.

[0047] Additional aspects and advantages of the present invention will be given in part in the following description and in part will be obvious from the following description, or will be learned through practice of the present invention. BRIEF DESCRIPTION OF THE DRAWINGS

[0048] The present invention is further described below in conjunction with the accompanying drawings and embodiments;

[0049] Figure 1 A schematic diagram of a flow chart of a method for monitoring blood flow after flap transfer in an embodiment;

[0050] Figure 2 A schematic diagram of a process of determining a first coordinate set and a second coordinate set in one embodiment;

[0051] Figure 3 It is a flow chart of a method for monitoring blood flow after flap transfer surgery in another embodiment;

[0052] Figure 4 A schematic diagram of the principle of determining a first coordinate set and a second coordinate set in one embodiment;

[0053] Figure 5 It is a schematic diagram of the principle of adjusting the posture of the imaging device in one embodiment. DETAILED DESCRIPTION

[0054] This section will describe in detail specific embodiments of the present invention. Preferred embodiments of the present invention are shown in the accompanying drawings. The role of the drawings is to supplement the description in the text part of the specification, enabling people to intuitively and vividly understand each technical feature and the overall technical solution of the present invention. However, it should not be construed as a limitation on the protection scope of the present invention.

[0055] As Figure 1 shown, in one embodiment, a method for monitoring blood circulation after flap transfer is provided. The method includes:

[0056] Step S202, obtaining a plurality of first temperature values corresponding to a plurality of first points in a first region of the free flap transferred to the recipient area, and calculating a first average temperature T1; wherein, the first region is the region corresponding to the target blood vessel running area on the surface of the free flap transferred to the recipient area; the target blood vessel is the blood vessel anastomosed with the blood supply vessel of the recipient area.

[0057] Step S204, obtaining a plurality of second temperature values corresponding to a plurality of second points in a second region of the free flap transferred to the recipient area, and calculating a second average temperature T2; wherein, the second region is the other region on the surface of the free flap transferred to the recipient area except the first region.

[0058] Step S206, obtaining a plurality of third temperature values corresponding to a plurality of third points in the normal skin area near the free flap transferred to the recipient area, and calculating a third average temperature T3.

[0059] Step S208, based on the relationship among the first average temperature T1, the second average temperature T2, and the third average temperature T3, execute a preset alarm prompt strategy; wherein, the preset alarm prompt strategy includes: if T1 < T2 < T3 and T3 - (T1 + T2) / 2 < θ, then issue a first-level alarm prompt for blood circulation disorder; if T3 - (T1 + T2) / 2 ≥ θ, then issue a second-level alarm prompt for blood circulation disorder; if T1 > T3, or T2 > T3, then issue an infection and inflammation alarm prompt; θ is a preset temperature difference threshold.

[0060] It is understandable that in the prior art, such as Patent Document 1, a vascular crisis alarm (i.e., the second-level alarm prompt of this embodiment) can only be issued when the temperature of the skin flap is 3 degrees Celsius lower than the normal skin temperature nearby. At this time, the degree of vascular obstruction may be relatively deep, and there is a problem of late intervention time. In this embodiment, a first-level alarm prompt can be triggered before the second-level alarm prompt, and the signs of blood supply obstruction of the skin flap can be found earlier by comparing the temperature difference between the target blood vessel running area and the non-target blood vessel running area inside the skin flap. Because the temperature of the blood vessel running area is higher than the surrounding area, especially for free skin flaps, the target blood vessel is anastomosed with the blood supply blood vessel of the recipient area, and the temperature in the free skin flap is higher than other areas. If the temperature of the target blood vessel running area is lower than the temperature of other areas in the free skin flap, it means that the blood supply of the target blood vessel may be obstructed, and a first-level alarm prompt can be issued, prompting the doctor to further make more detailed blood supply observations on the skin flap at an earlier stage, such as capillary filling observations, so before the blood supply obstruction phenomenon corresponding to the second-level alarm prompt occurs, this embodiment can find earlier signs of blood supply obstruction and improve the sensitivity of identifying blood supply obstruction. Furthermore, in the present embodiment, there is no need to follow Reference 1, in which the selection of collection points for different patients is mainly affected by the operator. In the present embodiment, the positions of each collection point in the flap are clearly defined in advance for each patient, which can improve the consistency of evaluating the blood supply status of the flap after surgery.

[0061] As a further improvement, the method further includes:

[0062] At each preset monitoring time point, an infrared thermal imaging lens of an imaging device is used to capture an infrared thermal image of the affected area including the free skin flap and nearby normal skin.

[0063] The step of obtaining a plurality of first temperature values ​​corresponding to a plurality of first points in a first area of ​​the free skin flap transferred to the recipient area specifically includes:

[0064] Based on a preset first coordinate set, a plurality of first temperature values ​​corresponding to a plurality of first points in the first area are obtained from the infrared thermal image of the receiving area; wherein the coordinates in the first coordinate set are used to define the boundary of the first area.

[0065] For example, assuming that the number of first points to be selected is preset to 10, 10 coordinate points can be randomly selected from the first area as the corresponding first points. Each coordinate point of the infrared thermal image corresponds to a temperature value, so based on the coordinate point corresponding to the first point, the first temperature value corresponding to each coordinate point is obtained from the infrared thermal image of the affected area, thereby calculating the average of the 10 first temperature values ​​to obtain the first temperature mean value T1.

[0066] The step of obtaining a plurality of second temperature values ​​corresponding to a plurality of second points in a second area of ​​the free flap transferred to the recipient area specifically includes:

[0067] Based on a preset first coordinate set and a second coordinate set, a plurality of second temperature values ​​corresponding to a plurality of second points in a second area are obtained from the infrared thermal image of the affected area; wherein the coordinates in the second coordinate set are used to define the boundary of a free skin flap transferred to the affected area.

[0068] For example, assuming that the number of second points to be selected is preset to 10, 10 coordinate points can be randomly selected from the second area as the corresponding second points. Each coordinate point of the infrared thermal image corresponds to a temperature value, so based on the coordinate point corresponding to the second point, the second temperature value corresponding to each coordinate point is obtained from the infrared thermal image of the affected area, thereby calculating the average of the 10 second temperature values ​​to obtain the second temperature mean value T2.

[0069] The step of obtaining a plurality of third temperature values ​​corresponding to a plurality of third points in a normal skin area near the free flap transferred to the recipient area specifically includes:

[0070] Based on a preset second coordinate set, a plurality of third temperature values ​​corresponding to a plurality of third points in a normal skin area near the free flap transferred to the recipient area are obtained from the infrared thermal image of the recipient area.

[0071] For example, the part of the infrared thermal image of the affected area outside the second area belongs to the normal skin area near the free flap. Therefore, assuming that the number of third points to be selected is preset to 10, 10 coordinate points can be randomly selected from the normal skin area near the free flap as the corresponding third points. Each coordinate point of the infrared thermal image corresponds to a temperature value. Therefore, based on the coordinate point corresponding to the third point, the third temperature value corresponding to each coordinate point is obtained from the infrared thermal image of the affected area, thereby calculating the average of the 10 third temperature values ​​to obtain the third temperature mean value T3.

[0072] In this embodiment, at each preset monitoring time node, an infrared thermal imaging lens is used to capture an infrared thermal image including the free flap and nearby normal skin; and based on the preset first coordinate set and second coordinate set, the temperatures of multiple points in the three areas of the first area of ​​the flap, the second area, and the nearby normal skin area can be automatically acquired from the infrared thermal image. There is no need to manually select each point and collect the temperature point by point, thereby improving the efficiency of temperature collection at each point and improving the consistency of evaluating the blood circulation status of the postoperative flap.

[0073] In one embodiment, the imaging device is configured with a visible light lens and an infrared thermal imaging lens at the same time. Figure 2 and Figure 4 As shown, the first coordinate set and the second coordinate set are obtained through the following process:

[0074] Step S301, when the skin flap is still located in the donor area and is in a pedicled skin flap state, and when the imaging device is in a first posture, a visible light lens is used to capture a first donor area visible light image B including the pedicled skin flap 21, and an infrared thermal imaging lens is used to capture an infrared thermal image A of the donor area including the pedicled skin flap 21.

[0075] like Figure 4 As shown, in the infrared thermal image A of the donor area, it can be seen that the outline of the pedicled skin flap 21 is darker, while the area corresponding to the running area of ​​the target blood vessel 23 (i.e., the portion indicated by the dotted line in the infrared thermal image A of the donor area), i.e., the first area 24, has a higher brightness. The black square in the infrared thermal image A of the donor area is the pedicle 22, which is located at the intersection of the first area 24 and the outline of the pedicled skin flap 21, and its position is marked by the doctor in the infrared thermal image A of the donor area. Referring to the visible light image B of the first donor area, in the visible light image, only the outline of the pedicled skin flap 21 can be seen, and the area corresponding to the target blood vessel 23 cannot be seen.

[0076] Step S302: determining the first supply area visible light image and the supply area infrared thermal image based on a first mapping relationship between the visible light lens and the infrared thermal imaging lens. Figure 2 The second mapping relationship of the image coordinate system.

[0077] There is a definite conversion relationship between the camera coordinate system corresponding to the visible light lens and the image coordinate system corresponding to the first supply area visible light image B, and there is also a definite conversion relationship between the camera coordinate system corresponding to the infrared thermal imaging lens and the image coordinate system corresponding to the supply area infrared thermal image A. Since the first mapping relationship between the visible light lens and the infrared thermal imaging lens installed on the same imaging device can be obtained through calibration, the second mapping relationship between the image coordinate systems of the first supply area visible light image B and the supply area infrared thermal image A can be obtained based on the conversion relationship (i.e., mapping relationship) of the above three. The calibration between two lenses with a common field of view and the conversion relationship between the two image coordinate systems belong to the prior art and will not be repeated here.

[0078] Step S303, determining the running area of ​​the target blood vessel in the infrared thermal image of the donor area based on the target high temperature area connected to the pedicle in the infrared thermal image of the donor area.

[0079] Specifically, the point on the infrared thermal image of the supply area whose temperature difference with the pedicle does not exceed a preset second temperature difference threshold is defined as a high-temperature point, and all points in the high-temperature area are high-temperature points; the target high-temperature area connected to the pedicle means that there must be a high-temperature path in the path from any high-temperature point in the target high-temperature area to the pedicle; wherein, the high-temperature path means that all points on the path are high-temperature points.

[0080] like Figure 4 As shown in the infrared thermal image A of the donor area, assuming that the preset second temperature difference threshold is 0.5°C, the temperature difference with the pedicle 22 is no more than 0.5°C and the point can reach the pedicle 22 through a high-temperature path, and the point is located within the area enclosed by the outline of the pedicled flap 21, and the point is within the course area of ​​the target blood vessel. Specifically, the two unclosed ends of the outline of the pedicled skin flap 21 on the infrared thermal image A of the donor area can be connected with a straight line to obtain a closed area enclosed by the outline of the pedicled skin flap 21, and then starting from the coordinate point corresponding to the pedicle 22 in the closed area, all high-temperature points adjacent to the coordinate point of the pedicle 22 are checked one by one to obtain the first batch of high-temperature points; then all new high-temperature points adjacent to the first batch of high-temperature points are checked one by one to obtain the second batch of high-temperature points; and so on, the nth batch of high-temperature points can be obtained, until all coordinate points (i.e., points) adjacent to the nth batch of high-temperature points do not belong to the high-temperature point positions, and these n batches of high-temperature points together constitute the above-mentioned target high-temperature area. Then, a copy of the donor area infrared thermal image A is made, and the pixel values ​​of the coordinate points corresponding to the n batches of high-temperature points in the copied donor area infrared thermal image A are set to 1 (that is, the pixel values ​​of the target high-temperature area are set to 1), and all other positions are set to 0. Based on the contour extraction algorithm, a coordinate set of the contour (i.e., the boundary) corresponding to the target high-temperature area in the coordinate system of the donor area infrared thermal image A is obtained, that is, the first coordinate set, and the first coordinate set is used to limit the running area of ​​the target blood vessel 23 in the donor area infrared thermal image A.

[0081] It should be noted that the trajectory of the target blood vessel 23 is continuous, and the trajectory area corresponding to the target blood vessel 23 can be accurately captured through the above solution.

[0082] Step S304: determining the running area of ​​the target blood vessel in the first donor area visible light image B based on the running area of ​​the target blood vessel in the donor area infrared thermal image A and the second mapping relationship.

[0083] Specifically, in step S303, the running area of ​​the target blood vessel 23 in the infrared thermal image A of the donor area, that is, the contour coordinate set corresponding to the first area 24, that is, the first coordinate set, has been obtained. Therefore, the running area of ​​the target blood vessel 23 can be determined in the first donor area visible light image B by converting the second mapping relationship between the image coordinate systems of the first donor area visible light image B and the infrared thermal image A of the donor area. Through image processing technology, the contour corresponding to the running area of ​​the target blood vessel 23 can be displayed on the first donor area visible light image B, so that the doctor can draw a plurality of marking points 25 on the surface of the pedicled flap in the area corresponding to the running area of ​​the target blood vessel with reference to the first donor area visible light image B. It can be understood that the number of marking points 25 can be 3 or 4, and 3 or 4 marking points 25 of different shapes are drawn with a marking pen to facilitate the feature detection operation in the subsequent image registration algorithm.

[0084] Step S305, when the imaging device is in the first posture, use a visible light lens to capture a second donor area visible light image C including the pedicled skin flap 21 and multiple marking points 25; wherein the multiple marking points 25 are drawn in an area corresponding to the course area of ​​the target blood vessel 23 on the surface of the pedicled skin flap 21 with reference to the first visible light image B.

[0085] Step S306, after the skin flap becomes a free skin flap 26 transferred to the recipient area, and when the imaging device is in the second posture, a visible light lens is used to capture a visible light image D of the recipient area including the free skin flap 26, multiple marking points 25 and nearby normal skin, and an infrared thermal imaging lens is used to capture an infrared thermal image E of the recipient area including the free skin flap 26, multiple marking points 25 and nearby normal skin.

[0086] It should be noted that the multiple marking points 25 cannot be clearly observed in the infrared thermal image E of the receiving area, but can be clearly identified in the visible light image D of the receiving area.

[0087] Step S307 , obtaining a third mapping relationship between the image coordinate systems of the second donor area visible light image C and the recipient area visible light image D based on the multiple point pairs formed by the multiple marking points in the second donor area visible light image C and the recipient area visible light image D.

[0088] Specifically, a general image registration algorithm can be used to achieve registration of the second donor area visible light image C and the recipient area visible light image D. Since the free flap 26 needs to be sutured to the recipient area, its contour is different from that of the pedicled flap 21. Therefore, in this embodiment, it is actually only necessary to determine the position of the target blood vessel 23 in the recipient area visible light image D, without paying attention to whether the edge contour of the flap is aligned.

[0089] Step S308, based on the first mapping relationship, the second mapping relationship and the third mapping relationship, a set of coordinates (i.e., a first coordinate set) corresponding to the running area contour of the target blood vessel 23 in the infrared thermal image A of the donor area is converted to the coordinate system of the infrared thermal image E of the recipient area, and the first coordinate set is constructed using the set of coordinates converted to the coordinate system of the infrared thermal image E of the recipient area.

[0090] like Figure 4 As shown in the infrared thermal image E of the receiving area, based on the first coordinate set, the outline corresponding to the first area 24 is displayed in the infrared thermal image E of the receiving area.

[0091] Step S309: construct the second coordinate set based on a set of coordinates corresponding to the edge contour of the free flap 26 transferred to the recipient area in the infrared thermal image E of the recipient area.

[0092] like Figure 4 As shown in the infrared thermal image E of the affected area, in the infrared thermal image E of the affected area, the edge brightness of the free skin flap 26 is the lowest. Based on the contour extraction algorithm, a set of coordinates corresponding to the edge contour of the free skin flap 26 can be extracted to construct the second coordinate set. Specifically, when multiple coordinate sets corresponding to contours are extracted from the infrared thermal image E of the affected area, a coordinate set that intersects with the first coordinate set and has the most coordinates corresponding to the contour is selected as the second coordinate set. This method can eliminate the interference of other small contours. In an example, the contour detection function (such as findContours) in the OpenCV image processing library can be used for contour detection, and a list is returned in which each element represents a contour in the image. Each contour itself is a set consisting of a series of coordinate points, representing the boundary of the contour.

[0093] It is understandable that when the skin flap is transferred to the recipient area, the target blood vessel has not yet returned to normal state, and the target blood vessel's running area cannot be determined through the infrared thermal image of the recipient area. After the skin flap is transferred to the recipient area, the skin flap is sutured to the recipient area, so the free skin flap 26 transferred to the recipient area is slightly different from the pedicled skin flap 21 in the donor area in appearance, and the target blood vessel's running area in the visible light image of the recipient area cannot be determined by comparing the visible light image of the recipient area with the visible light image of the donor area. Therefore, the running area of ​​the target blood vessel 23 in the infrared thermal image E of the recipient area cannot be determined only by the infrared thermal imaging lens, and the running area of ​​the target blood vessel 23 in the infrared thermal image E of the recipient area needs to be determined through steps S301 to S309 provided in this embodiment, so as to monitor the first temperature value of the running area of ​​the target blood vessel 23, thereby achieving more precise postoperative observation.

[0094] like Figure 5As shown, in one embodiment, at each preset monitoring time node, when shooting with the infrared thermal imaging lens of the imaging device 10 to obtain an infrared thermal image of the affected area, a positioning auxiliary frame is displayed on the shooting interface 17, and the positioning auxiliary frame includes an inner frame 15 and an outer frame 16, the outline of the inner frame 15 is defined by a first coordinate set, and the outline of the outer frame 16 is defined by a second coordinate set.

[0095] Since the outline of the outer frame is defined by the second coordinate set, that is, the outline of the outer frame 16 is consistent with the outline of the free flap 26 transferred to the recipient area, when shooting, it is only necessary to make the outline of the outer frame 16 consistent with the outline of the free flap 26 transferred to the recipient area, so that the point corresponding to the target blood vessel 23 can be quickly determined based on the inner frame 15, thereby quickly determining the first temperature value of the point corresponding to the target blood vessel 23. And the positioning auxiliary frame shooting can improve the consistency of the infrared thermal image of the recipient area obtained each time.

[0096] As a further improvement, when entering the shooting interface 17 for the n+1th time at the preset monitoring time node, the current posture of the imaging device is identified based on the posture sensor. If it is identified that the current posture of the imaging device is different from the posture at the nth shooting, the posture guide control is displayed in the shooting interface; wherein the posture guide control is used to display in real time the difference between the current posture of the imaging device and the posture at the nth shooting, as well as the adjustment direction and amount of the difference.

[0097] Specifically, the difference includes the difference in the horizontal direction and the difference in the rotation angle around the vertical direction; Figure 5As shown, the posture guide control includes a horizontal guide control and a rotation guide control. The horizontal guide control includes a first object 11 that changes position in response to the horizontal posture of the imaging device and a fixed position positioning area 12. The first object 11 can be a circular icon, and the positioning area 12 can be a circular icon. By recording the position of the first object 11 compared to the positioning area 12 during the nth shooting, the horizontal posture data during the nth shooting can be represented. For example, when the first object 11 coincides with the positioning area 12 during the nth shooting, when entering the shooting interface for the n+1th time, it is also necessary to prompt the operator to adjust the horizontal posture of the imaging device 10 so that the first object 11 coincides with the positioning area 12. Obviously, the distance and angle between the first object 11 and the positioning area 12 displayed on the shooting interface 17 reflect the difference in the horizontal direction, and the operator can determine the direction and amount of adjustment by observing the difference between the first object 11 and the positioning area 12 on the shooting interface 17. The guidance of adjusting the horizontal direction in this embodiment is simple and easy to understand. Similarly, the rotation guide control includes a fixed-position positioning symbol 13 and a circular ring 14 that rotates in response to the rotation angle of the imaging device, and the circular ring 14 is provided with a corresponding degree. By recording the degree at which the positioning symbol 13 points to the circular ring 14 during the nth shooting, the posture data of the rotation angle during the nth shooting can be represented. For example, during the nth shooting, the positioning symbol 13 points to the position of 0° on the circular ring 14. When entering the shooting interface 17 for the n+1th time, the operation group should be guided to adjust the rotation of the imaging device 10 so that the positioning symbol 13 points to the position of 0° on the circular ring 14 again. Obviously, the actual degree at which the positioning symbol 13 displayed on the shooting interface 17 points to the circular ring 14 reflects the difference in the rotation direction, and the operator can determine the adjustment direction and adjustment amount of the rotation by observing the difference between the actual degree at which the positioning symbol 13 on the shooting interface 17 points to the circular ring 14 and the degree at which it points during the nth shooting. The guidance for adjusting the rotation direction in this embodiment is simple and easy to understand.

[0098] In one example, the horizontal guidance control determines the degree of horizontal direction correspondence based on the acceleration data detected by the accelerometer on the three axes XYZ, that is, when the position between the first object and the positioning area is in different states, the acceleration data measured by the accelerometer on the three axes XYZ is different. For example, when the mobile phone is in a horizontal state, the acceleration of gravity will act completely on the Z axis of the accelerometer, and the acceleration of the X axis and the Y axis is zero. If the mobile phone is tilted, the acceleration of gravity will be distributed on the X, Y, and Z axes. At this time, the tilt angle of the mobile phone can be calculated by measuring the acceleration on each axis. In one example, the rotation guidance control detects the angle between the imaging device and the geomagnetic north pole based on the magnetometer, that is, the orientation of the imaging device, which is the degree pointed by the mark on the ring. For example, when the imaging device is facing the geomagnetic north pole, the degree is 0°.

[0099] This embodiment can improve shooting efficiency, especially when a new operator is replaced, the operator can be quickly guided to adjust the posture of the imaging device 10 to a suitable posture. At the same time, by guiding the shooting posture, the consistency of the infrared thermal image of the affected area obtained each time is improved.

[0100] In one embodiment, the method further comprises:

[0101] If it is detected that from the monitoring result of the nmth time to the monitoring result of the nth time, in a total of (m+1) monitoring results, the first temperature mean corresponding to each monitoring result shows a decreasing or increasing trend and T1>T2 and T3-(T1+T2) / 2<θ, then the monitoring time node t_(n+1) of the n+1th time is adjusted to:

[0102] t_(n+1)=t_(n)+α*△t; wherein n and m are positive integers, and m<n; α is the correction coefficient, △t is the preset time interval between two adjacent monitoring time nodes; t_(n) is the nth monitoring time node, 1 / 3≤α≤3 / 4.

[0103] For example, if m=2, n=5, the monitoring results from the 3rd to the 5th time, a total of 3 times, show that the average value of the first temperature shows a decreasing trend. Although it does not trigger the first or second level alarm prompt of blood circulation disorder, it reflects the abnormality of blood circulation. Therefore, it is necessary to shorten the actual interval between the 6th and 5th measurements T1. In this example, α=1 / 2, △t is one hour. After the fifth shot is completed to measure the temperature, the next measurement should be performed half an hour later, so that the abnormality of blood circulation can be discovered as early as possible.

[0104] In summary, although the alarm state has not been met, the first temperature average value continues to decrease, indicating that the probability of blood circulation disorder is high, so it is necessary to increase the frequency of measurement to detect blood circulation disorder earlier. If the first temperature average value continues to rise, it means that the risk of inflammation is increasing. Therefore, this embodiment can detect possible signs of inflammation and infection in advance, so as to further observe and intervene before inflammation occurs.

[0105] like Figure 3 As shown, in one embodiment, the method further includes:

[0106] Step S402: At each preset monitoring time point, a visible light image of the affected area including the free skin flap and nearby normal skin is captured using a visible light lens of an imaging device.

[0107] Step S404: comparing the color of the free skin flap in the visible light image of the affected area with preset skin color data in a database.

[0108] Step S406: Determine the skin color score corresponding to the free flap based on the comparison result.

[0109] It should be noted that, in this example, color data is randomly collected from multiple positions in the free flap for comparison with the preset skin color data, so as to more fully reflect the skin color state of the flap as a whole. In the preset skin color data, multiple skin colors are set and corresponding scores are set for each skin color.

[0110] In this embodiment, in addition to temperature data, the skin color data of the skin flap can also be monitored. Using an imaging device for monitoring can collect multi-dimensional and more comprehensive data on skin flap blood circulation disorders, thereby improving monitoring efficiency and the accuracy of evaluating blood circulation disorders.

[0111] In one embodiment, a blood flow monitoring device after flap transfer is provided, comprising: a memory, a processor, and a computer program stored in the memory and executable on the processor, wherein the processor executes the steps of the blood flow monitoring method after flap transfer when executing the program. The steps of the blood flow monitoring method after flap transfer can be the steps in the above-mentioned embodiments.

[0112] In one embodiment, a computer-readable storage medium is further provided, wherein the computer-readable storage medium stores computer-executable instructions, wherein the computer-executable instructions are used to cause a computer to execute the steps of the blood supply monitoring method after flap transfer. The steps of the blood supply monitoring method after flap transfer here may be the steps of the blood supply monitoring method after flap transfer in the above-mentioned embodiments.

[0113] Those skilled in the art can understand that all or part of the processes in the above-mentioned embodiment methods can be completed by instructing the relevant hardware through a computer program, and the program can be stored in a non-volatile computer-readable storage medium. When the program is executed, it can include the processes of the embodiments of the above-mentioned methods. Among them, any reference to memory, storage, database or other media used in the embodiments provided in this application can include non-volatile and / or volatile memory. Non-volatile memory may include read-only memory (ROM), programmable ROM (PROM), electrically programmable ROM (EPROM), electrically erasable programmable ROM (EEPROM) or flash memory. Volatile memory may include random access memory (RAM) or external cache memory. As an illustration and not limitation, RAM is available in many forms, such as static RAM (SRAM), dynamic RAM (DRAM), synchronous DRAM (SDRAM), double data rate SDRAM (DDRSDRAM), enhanced SDRAM (ESDRAM), synchronous link (Synchlink) DRAM (SLDRA), memory bus (Rambus) direct RAM (RDRA), direct memory bus dynamic RAM (DRDRAM), and memory bus dynamic RAM (RDRAM).

[0114] The technical features of the above embodiments may be combined arbitrarily. To make the description concise, not all possible combinations of the technical features in the above embodiments are described. However, as long as there is no contradiction in the combination of these technical features, they should be considered to be within the scope of this specification.

Claims

1. A method for monitoring blood flow after flap transfer, characterized in that: The method includes: Obtaining a plurality of first temperature values corresponding to a plurality of first points in a first region of the free flap transferred to the recipient area, and calculating a first average temperature T1; wherein, the first region is the region corresponding to the target blood vessel running region on the surface of the free flap transferred to the recipient area; the target blood vessel is the blood vessel anastomosed with the blood supply vessel of the recipient area; Obtaining a plurality of second temperature values corresponding to a plurality of second points in a second region of the free flap transferred to the recipient area, and calculating a second average temperature T2; wherein, the second region is the other region of the surface of the free flap transferred to the recipient area except the first region; Obtaining a plurality of third temperature values corresponding to a plurality of third points in the normal skin area near the free flap transferred to the recipient area, and calculating a third average temperature T3; Based on the relationship among the first average temperature T1, the second average temperature T2, and the third average temperature T3, implementing a preset alarm prompt strategy; Wherein, the preset alarm prompt strategy includes: if T1 < T2 < T3 and T3 - (T1 + T2) / 2 < θ, then issue a first-level blood circulation disorder alarm prompt; if T3 - (T1 + T2) / 2 ≥ θ, then issue a second-level blood circulation disorder alarm prompt; if T1 > T3 or T2 > T3, then issue an infection and inflammation alarm prompt; θ is a preset temperature difference threshold.

2. The method for monitoring blood flow after flap transfer according to claim 1, characterized in that: The method further includes: At each preset monitoring time node, using the infrared thermal imaging lens of the imaging device to capture an infrared thermal image of the recipient area including the free flap and the nearby normal skin; The obtaining of the plurality of first temperature values corresponding to the plurality of first points in the first region of the free flap transferred to the recipient area specifically includes: Based on a preset first coordinate set, obtaining the plurality of first temperature values corresponding to the plurality of first points in the first region from the infrared thermal image of the recipient area; wherein, the coordinates in the first coordinate set are used to define the boundary of the first region; The obtaining of the plurality of second temperature values corresponding to the plurality of second points in the second region of the free flap transferred to the recipient area specifically includes: Based on the preset first coordinate set and second coordinate set, obtaining the plurality of second temperature values corresponding to the plurality of second points in the second region from the infrared thermal image of the recipient area; wherein, the coordinates in the second coordinate set are used to define the boundary of the free flap transferred to the recipient area; The obtaining of the plurality of third temperature values corresponding to the plurality of third points in the normal skin area near the free flap transferred to the recipient area specifically includes: Based on the preset second coordinate set, obtaining the plurality of third temperature values corresponding to the plurality of third points in the normal skin area near the free flap transferred to the recipient area from the infrared thermal image of the recipient area.

3. The method for monitoring blood flow after flap transfer according to claim 2, characterized in that: The imaging device is simultaneously equipped with a visible light lens and an infrared thermal imaging lens, and the first coordinate set and the second coordinate set are obtained through the following process: When the flap is still located in the donor area and in the state of a pedicled flap, and when the imaging device is in the first posture, using the visible light lens to capture a first donor area visible light image including the pedicled flap and using the infrared thermal imaging lens to capture a donor area infrared thermal image including the pedicled flap; Determine a second mapping relationship between the image coordinate systems of the first supply area visible light image and the supply area infrared thermal image based on a first mapping relationship between the visible light lens and the infrared thermal imaging lens; Determine the running area of ​​the target blood vessel in the infrared thermal image of the donor area based on the target high temperature area connected to the pedicle in the infrared thermal image of the donor area; Determine the running area of ​​the target blood vessel in the visible light image of the first donor area based on the running area of ​​the target blood vessel in the infrared thermal image of the donor area and the second mapping relationship; When the imaging device is in a first posture, a visible light lens is used to capture a second donor area visible light image including the pedicled skin flap and a plurality of marking points; wherein the plurality of marking points are drawn on the surface of the pedicled skin flap in an area corresponding to the running area of ​​the target blood vessel with reference to the first visible light image; After the skin flap becomes a free skin flap transferred to the recipient area, and when the imaging device is in a second posture, a visible light image of the recipient area including the free skin flap, a plurality of marking points and nearby normal skin is captured by a visible light lens, and an infrared thermal imaging lens is used to capture an infrared thermal image of the recipient area including the free skin flap, a plurality of marking points and nearby normal skin; Based on a plurality of point pairs formed by the plurality of marking points in the second donor area visible light image and the recipient area visible light image, a third mapping relationship between the image coordinate systems of the second donor area visible light image and the recipient area visible light image is obtained; Based on the first mapping relationship, the second mapping relationship and the third mapping relationship, a set of coordinates corresponding to the contour of the running area of ​​the target blood vessel in the infrared thermal image of the donor area is converted to the coordinate system of the infrared thermal image of the recipient area, and the first coordinate set is constructed by the set of coordinates converted to the coordinate system of the infrared thermal image of the recipient area; The second coordinate set is constructed based on a set of coordinates corresponding to the edge contour of the free skin flap transferred to the recipient area in the infrared thermal image of the recipient area.

4. The method for monitoring blood flow after flap transfer according to claim 3, characterized in that: The points on the infrared thermal image of the supply area whose temperature difference with the pedicle does not exceed the preset second temperature difference threshold are defined as high-temperature points, and all points in the high-temperature area are high-temperature points; the target high-temperature area connected with the pedicle means that there must be a high-temperature path among the paths from any high-temperature point in the target high-temperature area to the pedicle; wherein, the high-temperature path means that all points on the path are high-temperature points.

5. The method for monitoring blood flow after flap transfer according to claim 3, characterized in that: At each preset monitoring time node, when the infrared thermal imaging lens of the imaging device is used to shoot to obtain an infrared thermal image of the affected area, a positioning auxiliary frame is displayed on the shooting interface. The positioning auxiliary frame includes an inner frame and an outer frame. The outline of the inner frame is defined by a first coordinate set, and the outline of the outer frame is defined by a second coordinate set.

6. The method for monitoring blood flow after flap transfer according to claim 5, characterized in that: When entering the shooting interface for the n+1th time at a preset monitoring time node, the current posture of the imaging device is identified based on the posture sensor. If it is identified that the current posture of the imaging device is different from the posture at the nth shooting, the posture guide control is displayed in the shooting interface; wherein the posture guide control is used to display in real time the difference between the current posture of the imaging device and the posture at the nth shooting, as well as the adjustment direction and amount of the difference.

7. The method for monitoring blood flow after flap transfer according to claim 5, characterized in that: The method further comprises: If it is detected that from the monitoring result of the nmth time to the monitoring result of the nth time, in a total of (m+1) monitoring results, the first temperature mean corresponding to each monitoring result shows a decreasing or increasing trend and T1>T2 and T3-(T1+T2) / 2<θ, then the monitoring time node t_(n+1) of the n+1th time is adjusted to: t_(n+1)=t_(n)+α*△t; wherein n and m are positive integers, and m<n; α is the correction coefficient, △t is the preset time interval between two adjacent monitoring time nodes; t_(n) is the nth monitoring time node, 1 / 3≤α≤3 / 4.

8. The method for monitoring blood flow after flap transfer according to claim 3, characterized in that: The method further comprises: At each preset monitoring time point, using a visible light lens of an imaging device to capture a visible light image of the recipient area including the free skin flap and nearby normal skin; Comparing the color of the free skin flap in the visible light image of the recipient area with preset skin color data in a database; Based on the comparison results, the skin color score corresponding to the free flap is determined.

9. A computer-readable storage medium, characterized in that: The computer-readable storage medium stores computer-executable instructions, and the computer-executable instructions are used to enable a computer to execute the steps of any one of the methods in claims 1 to 8.

10. A blood flow monitoring device after flap transfer surgery, characterized in that: include: A memory, a processor, and a computer program stored in the memory and executable on the processor, wherein the processor executes the steps of any one of the methods of claims 1 to 8 when executing the program.

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