手指再植成活率的预后因素
Prognostic factors on survival rate of fingers replantation.
作者信息
Lima José Queiroz, Carli Alberto De, Nakamoto Hugo Alberto, Bersani Gustavo, Crepaldi Bruno Eiras, de Rezende Marcelo Rosa
机构信息
Universidade de São Paulo, Faculdade de Medicina, Hospital das Clínicas, São Paulo, SP, Brazil, Instituto de Ortopedia e Traumatologia do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil.
出版信息
Acta Ortop Bras. 2015 Jan-Feb;23(1):16-8. doi: 10.1590/1413-78522015230101026.
OBJECTIVE
To evaluate the factors that influence the survival rate of replantation and revascularization of the thumb and/or fingers.
METHODS
We included fifty cases treated in our department from May 2012 to October 2013 with total or partial finger amputations, which had blood perfusion deficit and underwent vascular anastomosis. The parameters evaluated were: age, gender, comorbidities, trauma, time and type of ischemia, mechanism, the injured area, number of anastomosed vessels and use of vein grafts. The results were statistically analyzed and type I error value was set at p <0.05 .
RESULTS
Fifty four percent of the 50 performed replantation survived. Of 15 revascularizations performed, the survival rate was 93.3%. The only factor that affected the survival of the amputated limb was the necessity of venous anastomosis.
CONCLUSION
We could not establish contraindications or absolute indications for the replantation and revascularization of finger amputations in this study. Level of Evidence III, Retropective Study.
目的
评估影响拇指和/或手指再植及血管重建存活率的因素。
方法
纳入2012年5月至2013年10月在我科治疗的50例全指或部分手指离断病例，这些病例存在血运灌注不足并接受了血管吻合术。评估的参数包括：年龄、性别、合并症、创伤、缺血时间和类型、机制、损伤部位、吻合血管数量及静脉移植的使用情况。对结果进行统计学分析，I类错误值设定为p<0.05。
结果
50例再植手术中有54%存活。15例血管重建手术中，存活率为93.3%。影响断肢存活的唯一因素是静脉吻合的必要性。
结论
在本研究中，我们未能确立手指离断再植及血管重建的禁忌证或绝对适应证。证据级别III，回顾性研究。
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