摘要
目的:探讨罂粟碱超前扩张血管在儿童指尖再植中的应用效果。方法:自2023年10月至2024年10月,我们对24例24指儿童指尖离断伤进行分组再植,采用罂粟碱超前扩张血管后行血管吻合(观察组)8例8指;未采用罂粟碱超前扩张,直接行血管吻合(对照组)16例16指。对比两组患儿的性别、年龄、损伤机制、离断平面以及术中血管吻合时间、一次吻合率、术后并发症发生率、再植成活率等,术后随访再植指体恢复情况,并按中华医学会手外科学会断指再植功能评定试用标准进行临床效果评定。统计学检验P<0.05表示差异有统计学意义。结果:术后24例再植指体存活23指,均获得随访,时间为1~10个月,平均3.2个月。在血管吻合时间及一次吻合率方面,罂粟碱超前扩张组(观察组)均优于直接血管吻合组(对照组),且差异有统计学意义(P<0.05)。在性别、年龄、损伤机制、离断平面、术后并发症发生率及再植成活率等指标上,两组的差异均无统计学意义(P>0.05)。结论:罂粟碱超前扩张可增加儿童指尖血管口径,显著改善血管的吻合条件,降低手术难度,扩大儿童指尖再植术的适用范围,具有临床应用价值。
Objective To investigate the efficacy of preemptive vasodilation with papaverine in pediatric fingertip replantation.MethodsFrom October 2023 to October 2024,24 cases of pediatric fingertip amputations(24 fingers)were divided into two groups for replantation.In the observation group(8 cases,8 fingers),papaverine was used to preemptively dilate blood vessels before vascular anastomosis.In the control group(16 cases,16 fingers),vascular anastomosis was performed directly without papaverine.The two groups were compared in terms of gender,age,injury mechanism,amputation level,intraoperative vascular anastomosis time,first-attempt anastomosis success rate,postoperative complication rate,and replantation survival rate.The follow-up evaluations were conducted to assess recovery,and the clinical outcomes were evaluated using the trial standard for functional evaluation of digital replantation by the Chinese Society of Hand Surgery.Statistical significance was defined as P<0.05.ResultsAmong the 24 replanted fingers,23 survived,with follow-up periods ranging from 1 to 10 months(mean,3.2 months).The observation group(papaverine pre-dilation)showed significantly shorter vascular anastomosis time and higher first-attempt anastomosis success rate compared to the control group(P<0.05).No statistically significant differences were observed between the two groups in gender,age,injury mechanism,amputation level,postoperative complication rate,or replantation survival rate(P>0.05).ConclusionPreemptive papaverine dilation increases vascular diameter in pediatric fingertips,significantly improving anastomotic conditions,reducing surgical difficulty,and expanding the applicability of fingertip replantation in children,demonstrating clinical value.
作者
华景辉
熊胜
黄小龙
巨积辉
邵卓恒
谢腾
郭峰
冯源
代圆圆
Hua Jinghui;Xiong Sheng;Huang Xiaolong;Ju Jihui;Shao Zhuoheng;Xie Teng;Guo Feng;Feng Yuan;Dai Yuanyuan(Department of Pediatric Orthopedics,Suzhou Ruihua Orthopedic Hospital,Suzhou 215104,China;Suzhou Medical College of Soochow University,Suzhou 215123,China)
出处
《中华手外科杂志》
北大核心
2025年第6期509-513,共5页
Chinese Journal of Hand Surgery
基金
苏州市应用基础研究(医疗卫生)科技创新项目(SYW2024060)
吴中区科技计划项目(WZYW2022033)。
