吲哚菁绿荧光成像技术辅助下胆道手术的围术期护理的研究进展
Research Progress on Perioperative Nursing of Biliary Tract Surgery Assisted by Indocyanine Green Fluorescence Imaging Technology
摘要: 吲哚菁绿(Indocyanine Green, ICG)荧光成像技术在胆道手术中的应用已从辅助可视化工具逐步演变为提升手术安全性和精准度的核心技术。该技术正在重塑胆道外科的围手术期护理标准,从传统经验型护理向精准导航护理转型,对护理专业技能提出了新的、更高的要求。本文旨在系统梳理ICG荧光成像技术在胆道手术的应用,围手术期护理中的应用进展,并探讨未来吲哚菁绿荧光成像技术在胆道手术围手术期护理的优化方向,为构建基于可视化技术的精准护理体系提供理论支撑。
Abstract: The application of Indocyanine Green (ICG) fluorescence imaging technology in biliary tract surgery has gradually evolved from an auxiliary visualization tool into a core technology for enhancing surgical safety and precision. This technology is reshaping the perioperative nursing standards in biliary surgery, facilitating a transition from traditional experience-based nursing to precision-guided nursing, and imposing new and higher demands on nursing professional skills. This article aims to systematically review the applications of ICG fluorescence imaging technology in biliary tract surgery, summarize the progress of its perioperative nursing applications, and explore future directions for optimizing ICG fluorescence imaging technology in perioperative nursing care for biliary surgery, thereby providing theoretical support for the construction of a precision nursing system based on visualization technology.
文章引用:谢焕霞, 李可, 赖妙婷. 吲哚菁绿荧光成像技术辅助下胆道手术的围术期护理的研究进展[J]. 临床医学进展, 2026, 16(9): 2356-2365. https://doi.org/10.12677/acm.2026.1693279

参考文献

[1] 周晨阳. 吲哚菁绿荧光导航技术结合MRCP在肝外变异胆管识别中的应用[D]: [硕士学位论文]. 济宁: 济宁医学院, 2025.
[2] 李峥, 杨海峰. 吲哚菁绿荧光成像技术在胆道外科手术中的应用及研究进展[J/OL]. 腹部外科: 1-6.
https://link.cnki.net/urlid/42.1252.R.20260710.1547.006, 2026-09-22.
[3] Cherrick, G.R., Stein, S.W., Leevy, C.M. and Davidson, C.S. (1960) Indocyanine Green: Observations on Its Physical Properties, Plasma Decay, and Hepatic Extraction. Journal of Clinical Investigation, 39, 592-600.
https://doi.org/10.1172/jci104072
[4] Vahrmeijer, A.L., Hutteman, M., van der Vorst, J.R., van de Velde, C.J.H. and Frangioni, J.V. (2013) Image-Guided Cancer Surgery Using Near-Infrared Fluorescence. Nature Reviews Clinical Oncology, 10, 507-518.
https://doi.org/10.1038/nrclinonc.2013.123
[5] Huang, H., Du, D., Wang, Z., Xie, Y., Ni, Z., Li, X., et al. (2023) Application of Intraoperative Fluorescence Imaging with Indocyanine Green in the Difficult Gallbladder: A Comparative Study between Indocyanine Green-Guided Fluorescence Cholangiography and Conventional Surgery. Journal of Laparoendoscopic & Advanced Surgical Techniques, 33, 404-410.
https://doi.org/10.1089/lap.2022.0467
[6] Panin, S.I., Nechay, T.V., Sazhin, A.V., et al. (2026) Intraoperative Differences between Near-Infrared Fluorescence Cholangiography with Indocyanine Green and Conventional White Light Laparoscopic Cholecystectomy: An Integrative Review of Evidence Base. BMC Surgery, 26, Article No. 178.
https://doi.org/10.1186/s12893-026-03549-0
[7] Wang, W., Feng, S., Li, Z., Qiao, Z., Yang, L., Han, L., et al. (2024) Clinical Application of Indocyanine Green Fluorescence Navigation Technique in Laparoscopic Common Bile Duct Exploration for Complex Hepatolithiasis. BMC Surgery, 24, Article No. 456.
https://doi.org/10.1186/s12893-024-02411-5
[8] 朱超, 刘会春, 王勇, 等. 吲哚菁绿荧光显影在腹腔镜再次胆道探查术中的应用研究[J]. 腹腔镜外科杂志, 2024, 29(5): 358-362.
[9] Yanagi, Y., Yoshimaru, K., Matsuura, T., et al. (2019) The Outcome of Real-Time Evaluation of Biliary Flow Using Near-Infrared Fluorescence Cholangiography with Indocyanine Green in Biliary Atresia Surgery. Journal of Pediatric Surgery, 54, 2574-2578.
https://doi.org/10.1016/j.jpedsurg.2019.08.029
[10] 郑州大学第三附属医院. 小小荧光引航向, 45天胆道闭锁宝宝重获新生[EB/OL].
https://www.zdsfy.net/yydt/146268.jhtml, 2026-09-22.
[11] Ishizawa, T., Tamura, S., Masuda, K., Aoki, T., Hasegawa, K., Imamura, H., et al. (2009) Intraoperative Fluorescent Cholangiography Using Indocyanine Green: A Biliary Road Map for Safe Surgery. Journal of the American College of Surgeons, 208, e1-e4.
https://doi.org/10.1016/j.jamcollsurg.2008.09.024
[12] Zhou, J., Tan, Z., Sun, B., Leng, Y. and Liu, S. (2024) Application of Indocyanine Green Fluorescence Imaging in Hepatobiliary Surgery. International Journal of Surgery, 110, 7948-7961.
https://doi.org/10.1097/js9.0000000000001802
[13] 陈江明, 蒋东方, 方康伟, 等. 腹腔镜胆囊切除术中吲哚菁绿肝外胆道显影的术前给药时间和剂量研究[J]. 中华消化外科杂志, 2025, 24(7): 882-889.
[14] 王晓颖. 吲哚菁绿荧光成像技术在肝脏外科应用中国专家共识(2023版) [J]. 中国实用外科杂志, 2023, 43(4): 371-383.
[15] 宗雨, 胡利国. 围手术期过敏反应[J]. 国际麻醉学与复苏杂志, 2018, 39(10): 982-986.
[16] 中国医师协会外科医师分会胆道外科医师委员会. 胆道手术加速康复外科专家共识(2016版) [J]. 中华消化外科杂志, 2017, 16(1): 6-13.
[17] 李薇. 胆道肿瘤患者的营养治疗共识[J]. 肿瘤代谢与营养电子杂志, 2021, 8(3): 257-264.
[18] 刘银秀, 孙桂菊. 营养支持在加速康复外科中的应用[C]//中国营养学会, 中国疾病预防控制中心营养与健康所, 农业农村部食物与营养发展研究所, 中国科学院上海营养与健康研究所, 华中科技大学公共卫生学院. 中国营养学会第十五届全国营养科学大会论文汇编. 2022: 553.
[19] 中华医学会外科学分会胆道外科学组, 白求恩公益基金会肝胆专业委员会, 中华外科杂志编辑部. 加速康复理念在梗阻性黄疸规范治疗中应用的专家共识[J]. 中华外科杂志, 2021, 59(4): 241-248.
[20] 刘付宝, 蒋东, 耿小平. 吲哚菁绿荧光成像技术在胆道疾病中的应用[J]. 中华消化外科杂志, 2024, 23(1): 80-84.
[21] 金涛, 王荇, 史凯航, 等. 吲哚菁绿荧光成像在感染性胆囊炎手术中的应用及病原学关联研究进展[J]. 中国病原生物学杂志, 2025, 20(10): 1378-1382.
[22] 邹婷. 多学科协作模式下心肺康复在肝胆胰外科围手术期的应用策略[J]. 国际护理学研究, 2026, 8(3): 60-65.
[23] 肝胆胰外科加速康复知识手册[EB/OL].
https://www.zy91.com/content/default2/77/8423, 2025-12-06.
[24] 皮启飞, 殷素鹏, 孙乙曾, 等. 吲哚菁绿荧光成像技术用于甲状腺全切除术中甲状旁腺血供判断的研究[J]. 中国普外基础与临床杂志, 2022, 29(10): 1313-1317.
[25] 腹部手术后的呼吸功能恢复护理方案[EB/OL].
https://m.book118.com/html/2025/1124/8045100060010013.shtm, 2025-11-25.
[26] Vu. V.Q., Le, V.T., Nguyen, H.N.A., Dang, K.K. and Luong, M.V.A. (2023) Preliminary Results of Laparoscopic Cholecystectomy Using Real-Time Indocyanine Green Fluorescence: A Cross-Sectional Study. Annals of Medicine and Surgery, 85, 402-406.
[27] 冯其柱, 王思雨, 张超. 吲哚菁绿荧光显影在困难胆囊腹腔镜胆囊切除术中的应用价值[J]. 临床肝胆病杂志, 2022, 38(11): 2537-2541.
[28] 许仙, 陆晓燕, 李红燕. 肝脏疾病患者术前行吲哚菁绿清除试验的心理状况调查及影响因素分析[J]. 中国现代医药杂志, 2023, 25(3): 89-92.
[29] 陈志, 周荣华, 朱任飞, 等. 吲哚菁绿荧光成像技术在腹腔镜困难型胆囊切除术中的应用研究[J]. 重庆医学, 2022, 51(17): 2984-2987, 2992.
[30] 杜金柱, 高才植, 高允海. 吲哚菁绿荧光显像在复杂腹腔镜胆囊切除术中的初步应用观察[J]. 中华肝胆外科杂志, 2020, 26(8): 595-599.
[31] Rahate, N.P., Kapse, A., Rahate, P.V. and Nimbhorkar, S.P. (2023) The Wonder Dye: Uses and Implications of Indigocyanine Green in Various Surgeries. Cureus, 15, e46722.
[32] Yoo, D. (2024) Laparoscopic Cholecystectomy for a Gallbladder with a Short Cystic Duct Draining to the Accessory Right Anterior Hepatic Duct Using Indocyanine Green Fluorescence Imaging: A Case Report. International Journal of Surgery Case Reports, 121, Article 110014.
[33] Liu, D., Wang, Y., Xue, F., Fu, J., Zhao, X., Song, S. and Gu, J. (2025) Comparative Analysis of Indocyanine Green Dosages for Optimal Fluorescence Imaging in Laparoscopic Cholecystectomy. Scientific Reports, 15, Article No. 13491.
[34] Xie, Q., Yang, M., Jiang, K., Zhang, L., Mao, T. and Gao, F. (2023) Laparoscopic Cholecystectomy Assisted by Combined Intravenous and Intracholecystic Fluorescent Cholangiography: A Case Report. Journal of International Medical Research, 51, 1-8.
[35] 《胆囊切除术中决策与转归的多协会共识和实践指南》解读[EB/OL].
https://m.book118.com/html/2026/0324/8111115007010056.shtm, 2026-03-25.
[36] Ravikumar, S., Musham, R., Vardhan Rao, G.V. and Eppa, V.R. (2025) Impact of Indocyanine Green (ICG) Fluorescence Cholangiography on Operative Time and Safety in Laparoscopic Cholecystectomy: A Prospective Randomized Controlled Study. Cureus, 17, e88639.
[37] 邹浩. 荧光腹腔镜胆囊切除术[J]. 中华普外科手术学杂志(电子版), 2020, 14(3): 231.
[38] Hanaki, T., Tokuyasu, N., Sakamoto, T. and Fujiwara, Y. (2022) Hepatectomy Guided by Indocyanine Green Fluorescent Imaging for Visualizing Bile Leakage (with Video). Clinical Case Reports, 10, e05942.
https://doi.org/10.1002/ccr3.5942
[39] 黄宇, 翁杰锋. 吲哚菁绿荧光显影术中胆漏1例并文献复习[J]. 腹腔镜外科杂志, 2024, 29(12): 955-957.
[40] 朱霞, 王铭, 杜凌遥, 等. 吲哚菁绿清除试验在肝脏储备功能评估中的临床应用新进展[J]. 胃肠病学和肝病学杂志, 2026, 35(1): 1-4.
[41] 钟潇珩, 彭芳松, 金昌, 等. ICG荧光成像技术在肝胆手术及预防并发症的应用进展[J]. 肝胆外科杂志, 2025, 33(6): 463-466.
[42] 王潇宁, 吴硕东, 韩金岩, 等. 荧光导航技术在防止胆道损伤、发现胆漏中的作用[J]. 中华医学杂志, 2023, 103(16): 1242-1244.
[43] 中国研究型医院学会肝胆胰外科专业委员会, 《中华消化外科杂志》编辑委员会. 围手术期肝脏储备功能评估专家共识(2025版) [J]. 中华消化外科杂志, 2025, 24(11): 1383-1396.
[44] Li, X., Wang, P., Su, S., Gan, Y., Yang, X., Peng, F., et al. (2023) Detection of the Intraoperative Bile Leakage in Laparoscopic Cholecystectomy Using Indocyanine Green Fluorescence Imaging: A Case Report. Heliyon, 9, e14040.
https://doi.org/10.1016/j.heliyon.2023.e14040
[45] Huerta, M., Dalmau, M., Fernandes, N., Dopazo, C., Caralt, M., Vidal, L., Charco, R., Bilbao, I. and Gómez-Gavara, C. (2025) Brightening the Path to Safe Liver Transplants: The Role of ICG Fluorescence in Biliary Anastomosis. BMJ Surgery, Interventions, & Health Technologies, 7, e000322.
[46] Broderick, R.C., Lee, A.M., Cheverie, J.N., Zhao, B., Blitzer, R.R., Patel, R.J., et al. (2021) Fluorescent Cholangiography Significantly Improves Patient Outcomes for Laparoscopic Cholecystectomy. Surgical Endoscopy, 35, 5729-5739.
https://doi.org/10.1007/s00464-020-08045-x