摘要
目的探讨断指再植改良血管套接法对患者断指血运、成活率及运动功能的影响。方法回顾性选取2019年2月至2021年12月菏泽市中医医院收治的断指再植患者80例,依据血管吻合方法分为改良血管套接法组、血管端端吻合法组两组,各40例。统计分析两组患者的断指血运、断指成活情况、运动功能、疼痛程度、生活质量、手术后并发症发生情况。结果改良血管套接法组患者的患肢微循环障碍血管/总血管低于血管端端吻合法组,经皮氧分压高于血管端端吻合法组,氧饱和度高于血管端端吻合法组,温度差异低于血管端端吻合法组,毛细血管充盈时间短于血管端端吻合法组,差异均有统计学意义(P<0.05)。改良血管套接法组患者的断指颜色正常率为82.50%,高于血管端端吻合法组(62.50%),断指张力正常率为82.50%,高于血管端端吻合法组(60.00%),断指成活率为87.50%,高于血管端端吻合法组(67.50%),差异均有统计学意义(P<0.05)。手术后,改良血管套接法组患者的肌力、灵巧度、活动度评分及总分均明显高于血管端端吻合法组,差异均有统计学意义(P<0.05)。手术后2 h、12 h、1 d、2 d,改良血管套接法组患者的视觉模拟评分法(VAS)评分均明显低于血管端端吻合法组,差异均有统计学意义(P<0.05)。手术后,改良血管套接法组患者的环境、心理、生理、社会关系领域评分均明显高于血管端端吻合法组,差异均有统计学意义(P<0.05)。两组患者的手术后并发症发生率比较,差异无统计学意义(P>0.05)。结论断指再植改良血管套接法较血管端端吻合法更能有效改善患者的断指血运、成活率及运动功能,值得推广。
Objective To investigate the influence of modified vascular sheath replantation on blood flow,survival rate and motor function of amputated finger.Methods A total of 80 patients with severed finger replantation admitted to Heze Hospital of Traditional Chinese Medicine from February 2019 to December 2021 were retrospectively selected and divided into two groups according to the vascular anastomosis method:the improved vascular sleeve method group and the vascular end-to-end anastomosis group.40 cases in each group.The blood supply of amputated fingers,the survival of amputated fingers,motor function,pain level,quality of life,and postoperative complications of the two groups were statistically analyzed.Results The microcirculation of the affected limb in the modified vascular anastomosis group was lower than that in the end-to-end anastomosis group,the percutaneous oxygen partial pressure was higher than that of the end-to-end anastomosis group,oxygen saturation was higher than that of the end-to-end anastomosis group,the temperature difference was lower than that of the end-to-end anastomosis group,capillary filling time was shorter than end-to-end anastomosis group,the differences were statistically significant(P<0.05).The normal color rate of the modified vascular anastomosis group was 82.50%,which was higher than that of the vascular end-to-end anastomosis group(62.50%),the normal rate of finger tension was 82.50%,which was higher than that of end-to-end anastomosis group(60.00%),the survival rate of finger amputation was 87.50%,which was higher than that of end-to-end anastomosis group(67.50%),the differences were statistically significant(P<0.05).After anastomosis,muscle strength,dexterity,mobility and total scores of patients in the modified vascular anastomosis group were higher than those in the end-to-end anastomosis group,the differences were statistically significant(P<0.05).At 2 h,12 h,1 d and 2 d after surgery,visual analogue scale(VAS)scores in the modified vascular anastomosis group were lower than those in the end-to-end anastomosis group,the differences were statistically significant(P<0.05).After anastomosis,the scores of environmental,psychological,physiological and social relationship in the modified vascular anastomosis group were higher than those in the end-to-end anastomosis group,the differences were statistically significant(P<0.05).There was no significant difference in the incidence of postoperative complications between the two groups(P>0.05).Conclusion Compared with the vascular end-to-end anastomosis,the modified vascular sheath replantation method can effectively improve the blood supply,survival rate and motor function of the severed finger,which is worthy of promotion.
作者
邓海防
刘林军
程成
陈茂松
秦长伟
刘伟涛
张涛
DENG Hai-fang;LIU Lin-jun;CHENG Cheng(Department of Hand and Foot Surgery,Heze Hospital of Traditional Chinese Medicine,Heze Shandong 274000,China)
出处
《临床和实验医学杂志》
2022年第18期1989-1992,共4页
Journal of Clinical and Experimental Medicine
基金
山东省教育厅科研课题(编号:60385b2098)。
关键词
断指再植
改良血管套接法
血管端端吻合法
断指血运
成活率
运动功能
Replantation of severed finger
Vascular end-to-end anastomosis
Modified vascular socket method
Blood transport of severed finger
The survival rate
Motor function
