Yin Shanqing, Zhang Chenxi, Huang YaoPeng, Liu linHai, Pan JiaDong, Wang Xin
Department of Plastic Reconstructive Surgery & Hand Microsurgery, Ningbo No. 6 Hospital, Ningbo, Zhejiang, China.
Ningbo Clinical Research Center for Orthopedics, Sports Medicine & Rehabilitation, Ningbo, Zhejiang, China.
Langenbecks Arch Surg. 2024 Dec 30;410(1):21. doi: 10.1007/s00423-024-03588-2.
The key to increasing the success rate of limb preservation lies in timely restoration of the blood supply to the severed limb, This study examines the clinical effect of a disposable intravenous infusion device as a temporary vascular shunt device which can quickly restore blood circulation in the replantation of severed limbs.
A retrospective review of all amputated major limbs in our department from May 2005 to May 2022. Patients treated with intravenous infusion tubes as temporary vascular shunt devices were included in group A(shunt group ) and those who could not use temporary intravascular shunt devices were included in group B (no shunt group). The durations of temporary vascular shunt placement and continuous placement during the operation were recorded, and the rates of limb survival and complications ( thrombosis and osteofascial compartment syndrome, infection) were evaluated after the operation. A comparison of complications, the postoperative function between the two groups was also performed.
A total of 67 patients were included: group A (shunt group, n = 35) and group B (no shunt group, n = 32), The average duration of temporary vascular shunt placement in all patients was 10 ± 1.5 min. The rate of amputation and the incidence of thrombus compartment syndrome and infection were statistically different between the two groups (P < 0.05), There was no significant difference in thrombosis rate between the two groups. All patients were followed up for a mean of 32.5 (8-60) months. The DASH scores of group A and group B at the last follow-up were 65 ± 8.5 points and 85 ± 6.5 points respectively and The Maryland foot scores of group A and group B at the last follow-up were 58 ± 4.5 points and 35 ± 5.5 points respectively, There were statistical differences in function between the two groups(P < 0.05).
A disposable intravenous infusion device as a temporary vascular shunt device can be effectively and practically used for reducing the warm ischemia time and significantly improving the successful limb replantation rate and is therefore worthy of clinical application.
提高肢体保留成功率的关键在于及时恢复离断肢体的血供，本研究探讨一次性静脉输液装置作为临时血管分流装置在断肢再植中快速恢复血液循环的临床效果。
回顾性分析2005年5月至2022年5月我院所有大肢体截肢患者。将使用静脉输液管作为临时血管分流装置治疗的患者纳入A组（分流组），不能使用临时血管内分流装置的患者纳入B组（无分流组）。记录手术中临时血管分流放置时间和持续放置时间，术后评估肢体存活率及并发症（血栓形成、骨筋膜室综合征、感染）发生率。比较两组并发症及术后功能。
共纳入67例患者：A组（分流组，n = 35）和B组（无分流组，n = 32）。所有患者临时血管分流平均放置时间为10±1.5分钟。两组截肢率、血栓形成、骨筋膜室综合征及感染发生率差异有统计学意义（P < 0.05），两组血栓形成率差异无统计学意义。所有患者平均随访32.5（8 - 60）个月。末次随访时A组和B组的DASH评分分别为65±8.5分和85±6.5分，A组和B组的马里兰足部评分分别为58±4.5分和35±5.5分，两组功能差异有统计学意义（P < 0.05）。
一次性静脉输液装置作为临时血管分流装置可有效且切实用于缩短热缺血时间，显著提高断肢再植成功率，值得临床应用。
