评估麻醉类型对手指再植手术成功率的影响。
Evaluating the Impact of Anesthesia Type on Finger Replantation Surgery Success.
作者信息
Mahmutoglu Saruhan, Cerikan Murat Dogus, Gungormez Egehan, Sevim Kamuran Zeynep, Kilinc Leyla
机构信息
Department of Plastic, Reconstructive and Aesthetic Surgery, University of Health Sciences Türkiye, Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Türkiye.
Department of Anesthesia and Reanimation, University of Health Sciences Türkiye, Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Türkiye.
出版信息
Sisli Etfal Hastan Tip Bul. 2025 Mar 18;59(1):15-19. doi: 10.14744/SEMB.2024.77503. eCollection 2025.
OBJECTIVES
Replantation surgery is one of the most difficult areas of reconstructive surgery. The aim of finger replantation is to restore sensation and adequate function of the amputated part in addition to restoring circulation. It is very crucial to investigate prognostic factors to improve the outcomes of this surgery. The type and severity of the injury, along with the duration between the injury and surgery, are the most significant factors influencing the success of replantation. This study investigates the impact of the type of anesthesia used on the success of replantation and other postoperative factors.
METHODS
The finger replantation operations performed in our clinic between December 2018 and December 2023 were retrospectively analyzed. The effects of gender, smoking, type of injury, vein repair, nerve repair, use of vein graft, level of injury, type of anesthesia, preoperative and postoperative hemoglobin values on replantation success were statistically investigated in 192 patients (162 males, 30 females). Ratios in independent groups were compared by chi-square test. Comparisons of numerical variables in the independent groups were conducted using the Mann-Whitney U test, as the assumption of normal distribution was not satisfied.
RESULTS
In the study, among the 192 patients, 91 received anesthesia via axillary nerve block (47.4%), 33 received general anesthesia (17.2%), and 28 received local anesthesia through digital block (14.6%). It was found that the type of anesthesia had no effect on the success of the replantation (p<0.05). A statistically significant difference was observed in the amount of change in hemoglobin levels between preoperative and postoperative measurements, according to the type of anesthesia. In the group receiving axillary nerve block, the decrease in hemoglobin levels was greater compared to the group receiving local anesthesia.
CONCLUSION
Our study found that smoking status and type of injury had no effect on the success of replantation.
目的
断指再植手术是重建外科中难度最大的领域之一。手指再植的目的除恢复血液循环外，还要恢复离断部位的感觉和足够的功能。研究预后因素对于改善该手术的效果至关重要。损伤的类型和严重程度，以及损伤与手术之间的时间间隔，是影响再植成功的最重要因素。本研究调查了所用麻醉类型对再植成功及其他术后因素的影响。
方法
回顾性分析2018年12月至2023年12月在我院进行的手指再植手术。对192例患者（162例男性，30例女性）的性别、吸烟情况、损伤类型、静脉修复、神经修复、静脉移植的使用、损伤平面、麻醉类型、术前和术后血红蛋白值对再植成功的影响进行了统计学研究。独立组间的比例采用卡方检验进行比较。由于不满足正态分布假设，独立组中数值变量的比较采用曼-惠特尼U检验。
结果
在本研究中，192例患者中，91例接受腋神经阻滞麻醉（47.4%），33例接受全身麻醉（17.2%），28例接受指根阻滞局部麻醉（14.6%）。发现麻醉类型对再植成功没有影响（p<0.05）。根据麻醉类型，术前和术后血红蛋白水平变化量存在统计学显著差异。接受腋神经阻滞的组中，血红蛋白水平的下降幅度比接受局部麻醉的组更大。
结论
我们的研究发现吸烟状况和损伤类型对再植成功没有影响。
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