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断指再植存活的术前预测因素。

Pre-operative predictive factors for the survival of replanted digits.

作者信息

Zhu Xiaozhong, Zhu Hongyi, Zhang Changqing, Zheng Xianyou

机构信息

Department of Orthopaedic Surgery, Shanghai Jiaotong University Affiliated Sixth People's Hospital, Shanghai, 200233, China.

Institute of Microsurgery on Extremities, Shanghai Jiaotong University Affiliated Sixth People's Hospital, Shanghai, 200233, China.

出版信息

Int Orthop. 2017 Aug;41(8):1623-1626. doi: 10.1007/s00264-017-3416-3. Epub 2017 Feb 4.

Abstract

PURPOSE

The primary objective of this study was to evaluate factors that influence the survival rate after digit replantation.

METHODS

A total of 291 digits of 200 patients who received digital replantation after complete amputation from 1 January 2014 to 31 December 2015 were included in this study. Univariate and multivariate analysis were performed to evaluate the correlation between potential risk factors and the failure rate. Age, gender, smoking status, Tamai level of amputation, causes of injury and ischemia time were recorded before replantation.

RESULTS

Age, smoking, causes of injury and ischemia time were pre-operative predictors for survival. On the contrary, gender and Tamai level did not alter the survival rate significantly. We divided patients into four groups according their smoking status: none, mild (<10 cigarettes per day), moderate (10-20 cigarettes per day) and heavy (>20 cigarettes per day). Our data demonstrated that the risks of failure only increased in heavy group.

CONCLUSIONS

Mild and moderate cigarette consumption (<20 cigarettes per day) did not increase the risk for replant failure of digits. Heavy (>20 cigarettes per day) cigarette consumption, increased age (>45 years), non-cut injury and prolonged ischemia time (>12 hours) were risk factors for replant failure.

摘要

目的

本研究的主要目的是评估影响断指再植术后存活率的因素。

方法

本研究纳入了2014年1月1日至2015年12月31日期间200例接受完全离断后断指再植患者的291根断指。进行单因素和多因素分析以评估潜在风险因素与失败率之间的相关性。再植术前记录年龄、性别、吸烟状况、玉井(Tamai)断指水平、损伤原因和缺血时间。

结果

年龄、吸烟、损伤原因和缺血时间是存活的术前预测因素。相反,性别和玉井断指水平对存活率无显著影响。我们根据患者的吸烟状况将其分为四组:不吸烟、轻度(每天<10支)、中度(每天10 - 20支)和重度(每天>20支)。我们的数据表明,仅重度吸烟组失败风险增加。

结论

轻度和中度吸烟(每天<20支)不会增加断指再植失败的风险。重度吸烟(每天>20支)、年龄增加(>45岁)、非切割伤和缺血时间延长(>12小时)是再植失败的风险因素。

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