摘要
目的探讨应用低分子肝素钙和应用皮瓣放血、按摩法等措施在抢救岛状皮瓣静脉危象临床效果的比较。方法 73例岛状皮瓣静脉危象,应用低分子肝素钙皮下注射47例(Ⅰ组),26例应用皮瓣放血、按摩法(Ⅱ组)。应用低分子肝素钙后监测活化部分凝血酶时间测定(activated partial thromboplastin time,APTT),活化凝血因子Ⅹ(Ⅹa),活化凝血因子Ⅱ(Ⅱa)活性。结果应用低分子肝素钙皮瓣成活率为(87.46±8.54)%明显高于应用对照组(34.37±6.43%),P<0.001;APTT在应用低分子肝素钙前后(0、2、4 h)明显延长(24.28±6.71、41.35±7.64、32.34±6.35),P<0.01;Ⅹa活性在应用低分子肝素钙前后(0、2、4 h)明显降低(152.4±30.7、65.8±24.4、83.4±18.4),P<0.01;Ⅱa活性在应用低分子肝素钙(0、2、4 h)为(155.70±31.61、143.20±24.75、143.4±23.35,P=NS,没有明显差异。结论应用低分子肝素钙抢救岛状皮瓣静脉危象,可大大提高皮瓣成活率,且没有对患者全身凝血功能造成不良影响。
Objective To evaluate the clinical efficacy of low molecular weight heparin（Fraxiparine） in rescuing venous crisis of island skin flap.Methods Of the 73 patients with venous crisis of island skin flap,47 received subcutaneous injection of low-molecular-weight heparin（group I） and 26 were treated with phlebotomy,local compression and topical application of unfractionated heparin solution gauze（group II）.Results The flap survival ratio was（88.46±8.64）% in group I and（38.37±6.53）% in group II（P〈0.001）.At 0,2,and 4 h after injection of low-molecular-weight heparin,the activated partial thromboplastin time（APTT） was obviously delayed（24.28±6.71,41.35±7.64 and 32.34±6.35,respectively,P0.01）,FXa：C level was significantly decreased（152.4±30.7,65.8±24.4 and 83.4±18.4,respectively,P〈0.01）,while FIIa：C level underwent no obvious alterations（155.70±31.61,143.20±24.75,and 143.4±23.35,respectively,P=NS）.Conclusion Fraxiparine has good antihrombotic efficacy in rescuing venous crisis of island skin flap without adverse effect on systemic coagulation. Kay words： venous crisis;low-molecular-weight heparin;island skin flap
出处
《南方医科大学学报》
CAS
CSCD
北大核心
2011年第9期1582-1584,共3页
Journal of Southern Medical University
基金
广东省自然科学基金070020)
广东省医学科学技术研究基金(A200703)
关键词
静脉危象
低分子肝素钙
岛状皮瓣
tomography
X-ray computed
angiography
digital model
virtual technology
virtual endoscope
colonic neoplasms
