BACKGROUND This study aims to describe the application of a modified St.Thomas'solution in patients with severe limb injuries.CASE SUMMARY Four patients who sustained a high-energy trauma and underwent complete up...BACKGROUND This study aims to describe the application of a modified St.Thomas'solution in patients with severe limb injuries.CASE SUMMARY Four patients who sustained a high-energy trauma and underwent complete upper limb amputation were pretreated with a modified St.Thomas'solution before upper limb replantation.After the perfusion solution stopped flowing from the blood vessel,the amputated upper limb amputation was replanted.The patients were instructed to perform functional rehabilitation training after the operation.All 4 patients were followed up for 5 years.All the severed upper limbs survived.Routine re-examination after the operation showed that the function of the affected limb was restored.All the patients were satisfied with the sensory and functional recovery of the affected limb.CONCLUSION The modified St.Thomas'solution can effectively improve the success rate of limb salvage surgery and the recovery of limb function in patients with a severe limb injury.展开更多
基金Supported by the National Natural Science Foundation of China,No.81600694the Science and Technology Project of Nanjing,No.201503008.
文摘BACKGROUND This study aims to describe the application of a modified St.Thomas'solution in patients with severe limb injuries.CASE SUMMARY Four patients who sustained a high-energy trauma and underwent complete upper limb amputation were pretreated with a modified St.Thomas'solution before upper limb replantation.After the perfusion solution stopped flowing from the blood vessel,the amputated upper limb amputation was replanted.The patients were instructed to perform functional rehabilitation training after the operation.All 4 patients were followed up for 5 years.All the severed upper limbs survived.Routine re-examination after the operation showed that the function of the affected limb was restored.All the patients were satisfied with the sensory and functional recovery of the affected limb.CONCLUSION The modified St.Thomas'solution can effectively improve the success rate of limb salvage surgery and the recovery of limb function in patients with a severe limb injury.
文摘目的探讨动态心电图参数联合血清成纤维细胞生长因子21(fibroblast growth factor 21,FGF21)、神经生长因子(nerve growth factor,NGF)对ST段抬高型心肌梗死(ST-segment elevation myocardial infarction STEMI)患者经皮冠状动脉介入治疗(percutaneous coronary intervention,PCI)术后室性心律失常的预测价值。方法回顾性选择2022年6月至2023年12月山东大学第四人民医院住院的STEMI患者187例,根据PCI术后72h内诊断结果分为室性心律失常组65例和非室性心律失常组122例。所有患者均接受PCI术,并于术后进行24 h动态心电图检查,采集心电图数据[正常窦性心搏间期的标准差(standard deviation of normal-to-normal intervals,SDNN)、相邻正常RR间期差值的均方根(root mean square of successive differences,rMSSD)、每5min时段内平均正常窦性心搏间期的标准差(standard deviation of the average normal-to-normal intervals per 5-minute period,SDANN-index)、QT间期变异性(QT interval variability,QTV)],检测血清FGF21、NGF水平,通过logistic回归分析室性心律失常危险因素,通过ROC曲线评估上述指标的预测价值。结果室性心律失常组SDNN、rMSSD、SDANN-index、QTV水平明显低于非室性心律失常组,血清FGF21、NGF水平明显高于非室性心律失常组,差异有统计学意义(P<0.01)。多因素logistic回归分析显示,PCI术后SDNN、rMSSD、SDANN-index、QTV、FGF21、NGF均为STEMI患者发生室性心律失常的危险因素(P<0.01)。ROC曲线分析显示,STEMI患者动态心电图参数SDNN、rMSSD、SDANN-index、QTV联合血清FGF21、NGF预测PCI术后室性心律失常发生的曲线下面积明显高于各项指标单独检测(0.852 vs 0.736、0.752、0.718、0.763、0.692、0.740(P<0.05)。结论STEMI患者PCI术后动态心电图参数联合血清FGF21、NGF对室性心律失常发生具有较高的预测价值,有助于早期识别高危患者。
