摘要
目的探讨小剂量肝素对断指再植术后患者血液流变学及肝功能的影响。方法回顾性分析2020年1月-2021年10月行断指再植术60例(64指)患者的临床资料,将其随机分为半量组30例(31指)和全量组30例(33指)。半量组予6250 U肝素钠持续微泵静滴,全量组予12500 U肝素钠持续微泵静滴。比较两组断指再植成活情况以及血管危象发生情况;比较治疗前后两组血液流变指标、凝血功能以及肝功能水平。结果两组断指成活率及血管危象发生率差异无统计学意义(P>0.05);治疗后两组红细胞沉降率以及血细胞比容较治疗前均有降低,组间差异无统计学意义(P>0.05);半量组治疗后凝血酶时间、活化部分凝血活酶时间、凝血酶原时间、谷丙转氨酶以及谷草转氨酶水平与治疗前差异无统计学意义(P>0.05),且上述指标水平均低于全量组(P<0.05)。结论小剂量肝素可帮助改善断指再植术后局部血液循环,改善血液流变学水平,降低血管危象风险,提升断指成活率,同时相较于常规剂量而言,其对患者机体凝血功能和肝功能水平的影响更小。
Objective To explore the effects of low-dose heparin on hemorheology and liver function in patients after severed finger replantation.Methods A total of 60 patients(64 fingers)undergoing severed finger replantation in the hospital were enrolled between January 2020 and October 2021.They were randomly divided into half-dose group(30 cases,31 fingers)and full-dose group(30 cases,33 fingers).The half-dose group was given 6250 U heparin sodium,while full-dose group was given 12500 U heparin sodium for continuous micro-pump intravenous drip.The survival of severed fingers and occurrence of vascular crisis,hemorheology indexes,coagulation function and liver function before and after treatment were compared between two groups.Results There was no significant difference in survival rate of severed fingers or incidence of vascular crisis between two groups(P>0.05).After treatment,erythrocyte sedimentation rate and hematocrit in both groups were decreased,but the difference between two groups was not statistically significant(P>0.05).In half-dose group,there was no significant difference in thrombin time,activated partial thromboplastin time,prothrombin time,alanine aminotransferase or aspartate aminotransferas before and after treatment(P>0.05),which were lower than those in full-dose group(P<0.05).Conclusion Low-dose heparin can improve local blood circulation and hemorheology,reduce the risk of vascular crisis and increase survival rate of severed fingers after replantation.Compared with routine dose,it has fewer effects on coagulation function and liver function.
作者
叶旭标
刘世峰
花宇
罗源生
刘雄
YE Xubiao;LIU Shifeng;HUA Yu(Department of Orthopedic Trauma,Dongguan Eighth People's Hospital,Dongguan,Guangdong,523000,China)
出处
《实用手外科杂志》
2023年第1期65-67,82,共4页
Journal of Practical Hand Surgery
关键词
小剂量
肝素
断指再植术
血液流变学
肝功能
Low dose
Heparin
Severed finger repl-antation
Hemorheology
Liver function
