Chen Xueming, Chen Zheng, Zhou Jiandong, Xu Yajun
Department of Hand Surgery, Wuxi 9th Affiliated Hospital of Soochow University, Wuxi, Jiangsu 214000, P.R. China.
Exp Ther Med. 2018 Jul;16(1):342-346. doi: 10.3892/etm.2018.6174. Epub 2018 May 17.
Curative effect of unilateral digital arterial ligation combined with low molecular weight heparins in the treatment of severed finger without venous anastomosis and its influence on venous crisis was studied. A total of 80 patients with distal severed finger treated in Wuxi No. 9 People's Hospital from May 2014 to July 2016 were selected into the study. According to the random number table, they were divided into the control group (n=40) and the research group (n=40). The patients in control group were treated with unilateral digital arterial ligation, while the patients in research group were treated with unilateral digital arterial ligation combined with low molecular weight heparin. The wound healing time after operation, hospitalization time, hemorheology detection results, survival rate and necrosis rate of replanted finger, incidence rate of venous crisis and recovery effect of replanted finger were compared between the two groups. After operation, the wound healing time and hospitalization time of patients in research group were lower than those in control group, and the differences were statistically significant (p<0.05). At 72 h after operation, the platelet adhesion rate, whole blood viscosity, whole blood low-shear viscosity, hematocrit and fibrinogen level in patients in research group were lower than those in control group, and the differences were statistically significant (p<0.05). At 7th day after operation, the survival rate of replanted finger in the research group was higher than that in control group, but the necrosis rate of replanted finger and incidence rate of venous crisis were lower than those in control group, and the differences were statistically significant (p<0.05). At 6 months after operation, the nail length, sensation, two-point discrimination and mobility of distal interphalangeal joint of patients in the research group were superior to those in control group, and the differences were statistically significant (p<0.05). Unilateral digital arterial ligation combined with low molecular weight heparin has a significant effect in the treatment of severed finger without venous anastomosis, which can effectively reduce or prevent the occurrence of venous crisis, improve the survival rate of replanted finger and promote the function recovery of replanted finger, so it is worthy of clinical promotion.
研究单侧指动脉结扎联合低分子肝素治疗无静脉吻合的断指的疗效及其对静脉危象的影响。选取2014年5月至2016年7月在无锡市第九人民医院治疗的80例末节断指患者纳入研究。根据随机数字表,将其分为对照组(n = 40)和研究组(n = 40)。对照组患者采用单侧指动脉结扎治疗,研究组患者采用单侧指动脉结扎联合低分子肝素治疗。比较两组患者术后伤口愈合时间、住院时间、血液流变学检测结果、再植指成活率和坏死率、静脉危象发生率及再植指恢复效果。术后,研究组患者的伤口愈合时间和住院时间均低于对照组,差异有统计学意义(p<0.05)。术后72 h,研究组患者的血小板黏附率、全血黏度、全血低切黏度、血细胞比容和纤维蛋白原水平均低于对照组,差异有统计学意义(p<0.05)。术后第7天,研究组再植指成活率高于对照组,再植指坏死率和静脉危象发生率低于对照组,差异有统计学意义(p<0.05)。术后6个月,研究组患者的指甲长度、感觉、两点辨别觉及远侧指间关节活动度均优于对照组,差异有统计学意义(p<0.05)。单侧指动脉结扎联合低分子肝素治疗无静脉吻合的断指疗效显著,可有效降低或预防静脉危象的发生,提高再植指成活率,促进再植指功能恢复,值得临床推广。