摘要
目的观察断指再植术后改良治疗方案对再植成活率和血管危象发生率的影响，探讨该方案的科学性和可行性。方法对2012年2月至2013年5月住院治疗的105例（129指）单指或双指断指再植的患者，其中46例（55指）术后采用改良治疗方案，抗凝血治疗中不使用低分子右旋糖酐药物，绝对卧床3d，再植指血运稳定的患者3d后允许在进食及如厕时起床、5d后下床可室内活动；59例（74指）采用传统治疗方案，常规抗感染、抗凝血及抗痉挛药物和绝对卧床7d。观察记录两组断指再植血管危象发生情况，并进行统计学分析。结果改良组再植成活率（96．4％）与常规组（97．3％）比较两组差异无统计学意义（P〉0．05）。术后患者舒适度调查两组差异有统计学意义（P〈0．05）。结论断指再植术后应用改良治疗方案，可以缩短患者卧床及住院时间，减少卧床并发症，提高了患者舒适度，同时对断指再植的成活率未造成影响，值得临床推广。
Objeelive To observe the survival rate and incidence of vascular crisis following a modified postoperative treatment scheme for finger replantation and investigate the rationale and practicability of this scheme. Methods From February 2012 to May 2013, 105 cases （129 digits） of single or double finger replantation were involved in the study. Among them 46 cases （55 digits） were treated with the modified postoperative therapeutic scheme. Low molecular weight dextran was not administered as part of the anticoagulant treatment. After 3 days of absolute bed rest, patients with stable blood perfusion of the replanted fingers were allowed to get up to eat and use the bathroom. They started ambulating in the hospital ward freely 5 days postoperatively. The other 59 cases （74 digits）were treated with the conventional postoperative scheme with regular anti-infection, anti-coagulation, anti-spasm therapy and absolute bed rest for 7 days. The occurrence of vascular crisis in all the patients was observed and recorded. The results of the two groups were compared statistically. Results The survival rates of replanted fingers between the modified therapeutic group（96.4% ） and the conventional group （97.3%） were not significantly different （ P 〉 0.05）. However,there was significant difference in the postoperative comfort scale（ P 〈 0.05）. Conclusion The modified postoperative therapeutic scheme following finger replantation can shorten the length of postoperative bed rest and hospital stay, reduce bed rest associated complications, increase postoperative comfort while not decreasing the survival rate of replanted fingers. It is worth wider clinical application.
出处
《中华手外科杂志》
CSCD
北大核心
2014年第2期110-112,共3页
Chinese Journal of Hand Surgery
关键词
再植术
指损伤
改良
Replantation
Finger injuries
Modify
