CAJ | 학술논문

目的：探讨断指再植术后改良治疗方案对再植指成活率和血管危象发生率的影响。方法将726例断指再植患者按治疗方法分为改良组和常规组，每组363例。观察术后改良治疗对两组血管危象发生率和再植成活率的影响。通过一段时间治疗，将两组中发生血管危象的120例归为观察组，未发生血管危象的606例归为对照组，对影响血管危象发生率的因素进行单因素和多因素分析。结果改良组和常规组血管危象发生率分别为7．4%和25．6%，差异有统计学意义( P <0．01)；观察组和对照组再植成活率分别为97．5%和85．0%，差异有统计学意义(P<0．01)。筛选出患者性别、年龄、吸烟史、受伤原因、缺血时间和离断平面6个影响血管危象发生率和再植成活率的因素，结果均有统计学意义(P<0．05)。结论改良治疗方案基于合理的用药理念，选用了有别于常规的不良反应小的三抗药物，根据患者再植指血运情况适当缩减患者的卧床时间，对患者进行术后心理干预和饮食护理，明显降低了术后血管危象的发生率，提高了断指再植的成活率。
목적：탐토단지재식술후개량치료방안대재식지성활솔화혈관위상발생솔적영향。방법장726례단지재식환자안치료방법분위개량조화상규조，매조363례。관찰술후개량치료대량조혈관위상발생솔화재식성활솔적영향。통과일단시간치료，장량조중발생혈관위상적120례귀위관찰조，미발생혈관위상적606례귀위대조조，대영향혈관위상발생솔적인소진행단인소화다인소분석。결과개량조화상규조혈관위상발생솔분별위7．4%화25．6%，차이유통계학의의( P <0．01)；관찰조화대조조재식성활솔분별위97．5%화85．0%，차이유통계학의의(P<0．01)。사선출환자성별、년령、흡연사、수상원인、결혈시간화리단평면6개영향혈관위상발생솔화재식성활솔적인소，결과균유통계학의의(P<0．05)。결론개량치료방안기우합리적용약이념，선용료유별우상규적불량반응소적삼항약물，근거환자재식지혈운정황괄당축감환자적와상시간，대환자진행술후심리간예화음식호리，명현강저료술후혈관위상적발생솔，제고료단지재식적성활솔。
Objective To investigate the survival rate and incidence of vascular crisis following a modified postopera-tive treatment scheme for finger replantation. Methods 726 cases of finger replantation patients were selected and divided into improved group and routine group, with 363 cases of each group. The effects of modified postoperative treatment in both groups were observed. Through a period treatment, vascular risk of 120 cases were classified as ob-servation group, vascular crisis not occurred 606 cases were classified as the control group. The possible influencing factors of the survival rate and vascular crisis were analyzed by single factors and Logistic regression analysis. Results The vascular crisis rate of improved group and routine group were 7. 4% and 25. 6% respectively (P<0. 01). The replantation survival rate of improved group and routine group were 97. 5% and 85. 0% respectively ( P<0. 01 ) . Gender, age, smoking history, causes of injury, ischemia duration and surface of division were influencing factors of the vascular crisis rate and survival rate after replantation, and the difference was statistically significant (P<0. 05). Conclusions The modified postoperative treatment scheme for finger replantation can reduce the vascular crisis and improve the survival rate of replanted fingers.