摘要
目的 分析影响断指再植术后发生血管危象的危险因素，为早期发现和及时防治血管危象的发生提供理论依据，从而减少断指再植术后血管危象的发生，提高断指再植的成活率。方法 回顾性分析712指断指再植的病例，将患者性别、年龄、指别、伤因、断指缺血时间、离断平面、是否完全离断、动脉修复情况、静脉修复情况共九个因素分别与是否发生血管危象进行单因素分析和亚变量多因素Logistic回归分析，探讨断指再植术后发生血管危象的独立预测因素。结果 712指断指再植术后共有132指发生血管危象，其中静脉危象44指，动脉危象88指，危象发生率为18．5％。单因素分析结果表明：性别、年龄、指别、伤因、离断平面、是否完全离断、动脉修复情况、静脉修复情况对血管危象的发生均有影响。二分类亚变量Logistic多因素分析表明，性别、年龄、伤因、离断平面、是否完全离断、动脉修复情况是断指再植术后发生血管危象的独立的预测因素。结论 性别、年龄、伤因、离断平面、是否完全离断、动脉修复情况是断指再植术后发生血管危象的独立的预测因素。对于发生血管危象机率高的患者术中要精细操作，术后密切观察，预防断指再植术后血管危象的发生。
Objective To analyze the risk factors of circulation crisis after digit replantation in order to establish the theoretic basis for reducing the morbidity of circulation crisis and increasing the survival rate of digit replantafion. Methods The 712 finger replantations were reviewed respectively. Nine parameters including age, sex, finger, cause of injury, ischemia duration, plane of division, complete or incomplete severance, condition of venous drainage, condition of arterial repair were analyzed as predictive risk factors for circulation crisis using single variant analysis and multi-variant logistic regression analysis in order to find the independent risk factors. Resets Circulation crisis occurred in 132 replanted fingers, including venous crisis in 44 fingers and arterial crisis in 88 fingers. Single variant analysis indicated that age, sex, finger, cause of injury, plane of division, complete or incomplete severance, condition of venous drainage, condition of arterial repair were significantly correlated with circulation crisis of the finger. The multi-variant logistic regression analyses showed that age, sex, cause of injury, plane of division, complete or incomplete severance, condition of arterial repair were the significant independent predictors for circulation crisis. Conclusion Age, sex, cause of injury, plane of division, complete or incomplete severance, condition of arterial repair are risk factors for circulation crisis in digit replantation. As a result, exactitude operation and close observation are essential to prevent circulation crisis in high-risk group.
出处
《中华手外科杂志》
CSCD
北大核心
2007年第1期38-40,共3页
Chinese Journal of Hand Surgery
关键词
指损伤
再植术
血管危象
影响因素
Finger injuries
Replantation
Circulatory crisis
Influencing factor
