He Shaoyi, Chen Weiting, Xia Jingzhao, Lai Zhongbin, Yu Di, Yao Ji, Cai Shuiqi
Department of Anesthesiology, The Third People's Hospital of Cixi City, Cixi, China.
Department of Hand Surgery, The Third People's Hospital of Cixi City, Cixi, China.
Ann Palliat Med. 2020 Sep;9(5):3332-3339. doi: 10.21037/apm-20-1467.
The study aimed to confirm the important role of ozone autologous blood therapy (autohemotherapy) in promoting successful finger replantation and its possible influence mechanism.
A total of 150 patients with severed finger replantation admitted to our hospital from March 2018 to March 2019 were selected. Patients were divided into observation group and control group according to different treatment methods. The observation group received additional ozone autologous blood treatment in the control group. We compared the number of white blood cells, visual analogue scale (VAS) scores, and the expression levels of vascular endothelial growth factor (VEGF), transforming growth factor-β (TGF-β), and platelet-derived growth factor (PDGF) in the two groups of patients before and after intervention. We also assessed the hospitalization time and survival time of the replanted finger in the two groups, as well as blood flow values (Vbcf).
Compared with the observation group on the 1st day after the operation and the control group on the 7th day after the operation, the average white blood cell count of the observation group on the 7th day after the operation was significantly increased (P<0.05), and the VAS score was significantly decreased (P<0.05).48 hours after the operation, the average Vbcf value of the replanted finger was lower than that of the contralateral healthy finger (P<0.05). Compared with the control group, the Vbcf value of the replanted fingers in the observation group was higher, and the hospitalization time and finger survival time were shorter (P<0.05). At 7 days after operation, the serum VEGF, TGF-β and PDGF levels in the observation group were significantly higher than the 1 day after operation, before the operation and the control group (P<0.05).
Intervention with ozone autohemotherapy after severed finger replantation can significantly increase the number of white blood cells, relieve postoperative pain, and improve the survival rate of the finger body. Ozone autohemotherapy also improves the microcirculation after anastomosis of the severed finger by up-regulating the expression of VEGF, TGF-β and PDGF in blood.
本研究旨在证实臭氧自血疗法（自体血液疗法）在促进断指再植成功中的重要作用及其可能的影响机制。
选取2018年3月至2019年3月我院收治的150例断指再植患者。根据不同治疗方法将患者分为观察组和对照组。观察组在对照组基础上接受额外的臭氧自血治疗。比较两组患者干预前后白细胞数量、视觉模拟评分（VAS）以及血管内皮生长因子（VEGF）、转化生长因子-β（TGF-β）和血小板衍生生长因子（PDGF）的表达水平。同时评估两组患者的住院时间和再植手指的存活时间以及血流值（Vbcf）。
术后第1天观察组与术后第7天对照组相比，术后第7天观察组平均白细胞计数显著升高（P<0.05），VAS评分显著降低（P<0.05）。术后48小时，再植手指的平均Vbcf值低于对侧健康手指（P<0.05）。与对照组相比，观察组再植手指的Vbcf值更高，住院时间和手指存活时间更短（P<0.05）。术后7天，观察组血清VEGF、TGF-β和PDGF水平显著高于术后1天、术前及对照组（P<0.05）。
断指再植后采用臭氧自血疗法干预可显著增加白细胞数量，缓解术后疼痛，提高手指成活率。臭氧自血疗法还通过上调血液中VEGF、TGF-β和PDGF的表达改善断指吻合后的微循环。
