中国医药
中國醫藥
중국의약
China Medicine
2015年
11期
1654-1656
,共3页
显微外科术%注射用七叶皂苷钠%甘露醇%再灌注损伤
顯微外科術%註射用七葉皂苷鈉%甘露醇%再灌註損傷
현미외과술%주사용칠협조감납%감로순%재관주손상
Microsurgery%Sodium aescinate for injection%Mannitol%Reperfusion injury
目的 探讨显微外科术后应用注射用七叶皂苷钠的临床疗效.方法 选取2012年1月至2014年1月在山东省滕州市中心人民医院手足外科行断指再植或皮瓣移植的患者60例,按就诊顺序随机分为观察组(33例)和对照组(27例).观察组给予注射用七叶皂苷钠20 mg溶于0.9％氯化钠注射液250 ml静脉滴注,1次/d;对照组给予甘露醇250 ml静脉滴注,1次/d.2组均术后即刻开始应用,连续应用7d.比较2组患者术前和术后7d血清丙二醛、超氧化物歧化酶(SOD)含量,并于术后2周比较2组患者临床疗效及不良反应发生情况.结果 观察组术后7d丙二醛含量明显高于治疗前并低于对照组同时点[(5.9 ±2.5) μmol/L比(3.8±1.5)、(7.6±3.1) μmol/L],SOD含量低于治疗前并高于对照组同时点[(99±11) U/ml比(106±6)、(92±9)U/ml],差异均有统计学意义(均P＜0.05).观察组治疗总有效率与对照组比较[94.0％(31/33)比92.6％ (25/27)],差异无统计学意义(x2=0.36,P＞0.05).观察组未发生不良反应,对照组1例肾功能受损,1例水电解质紊乱,均经治疗后恢复正常.结论 断指再植及皮瓣移植患者术后存在缺血再灌注损伤;注射用七叶皂苷钠能减轻显微外科术后缺血再灌注损伤,且无明显不良反应.
目的 探討顯微外科術後應用註射用七葉皂苷鈉的臨床療效.方法 選取2012年1月至2014年1月在山東省滕州市中心人民醫院手足外科行斷指再植或皮瓣移植的患者60例,按就診順序隨機分為觀察組(33例)和對照組(27例).觀察組給予註射用七葉皂苷鈉20 mg溶于0.9％氯化鈉註射液250 ml靜脈滴註,1次/d;對照組給予甘露醇250 ml靜脈滴註,1次/d.2組均術後即刻開始應用,連續應用7d.比較2組患者術前和術後7d血清丙二醛、超氧化物歧化酶(SOD)含量,併于術後2週比較2組患者臨床療效及不良反應髮生情況.結果 觀察組術後7d丙二醛含量明顯高于治療前併低于對照組同時點[(5.9 ±2.5) μmol/L比(3.8±1.5)、(7.6±3.1) μmol/L],SOD含量低于治療前併高于對照組同時點[(99±11) U/ml比(106±6)、(92±9)U/ml],差異均有統計學意義(均P＜0.05).觀察組治療總有效率與對照組比較[94.0％(31/33)比92.6％ (25/27)],差異無統計學意義(x2=0.36,P＞0.05).觀察組未髮生不良反應,對照組1例腎功能受損,1例水電解質紊亂,均經治療後恢複正常.結論 斷指再植及皮瓣移植患者術後存在缺血再灌註損傷;註射用七葉皂苷鈉能減輕顯微外科術後缺血再灌註損傷,且無明顯不良反應.
목적 탐토현미외과술후응용주사용칠협조감납적림상료효.방법 선취2012년1월지2014년1월재산동성등주시중심인민의원수족외과행단지재식혹피판이식적환자60례,안취진순서수궤분위관찰조(33례)화대조조(27례).관찰조급여주사용칠협조감납20 mg용우0.9％록화납주사액250 ml정맥적주,1차/d;대조조급여감로순250 ml정맥적주,1차/d.2조균술후즉각개시응용,련속응용7d.비교2조환자술전화술후7d혈청병이철、초양화물기화매(SOD)함량,병우술후2주비교2조환자림상료효급불량반응발생정황.결과 관찰조술후7d병이철함량명현고우치료전병저우대조조동시점[(5.9 ±2.5) μmol/L비(3.8±1.5)、(7.6±3.1) μmol/L],SOD함량저우치료전병고우대조조동시점[(99±11) U/ml비(106±6)、(92±9)U/ml],차이균유통계학의의(균P＜0.05).관찰조치료총유효솔여대조조비교[94.0％(31/33)비92.6％ (25/27)],차이무통계학의의(x2=0.36,P＞0.05).관찰조미발생불량반응,대조조1례신공능수손,1례수전해질문란,균경치료후회복정상.결론 단지재식급피판이식환자술후존재결혈재관주손상;주사용칠협조감납능감경현미외과술후결혈재관주손상,차무명현불량반응.
Objective To analyze the clinical application of sodium aescinate after microsurgery.Methods Sixty patients who underwent replantation of severed finger and skin flap transplantation were randomly divided into observation group (33 cases) given aescinate (20 mg dissolved into 250 ml 0.9％ sodium chloride, intravenous drip, 1 time/d), and control group (27 cases) given mannitol (250 ml, intravenous drip, 1 time/d);the treatment was given immediately after operation and lasted for 7 days.The level of malondialdehyde (MDA) and superoxide dismutase (SOD) activity in serum before and 7 days after operation were measured;the effect and adverse reactions 14 d after operation were observed and compared between the two groups.Results Seven days after operation, the serum MDA level was significantly increased and the serum SOD activity was significantly decreased in observation group, while were both significantly improved compared with those in control group [(5.9±2.5) μmol/Lvs (3.8±1.5), (7.6±3.1) μmol/L, (99±11) U/ml vs (106±6), (92 ± 9) U/ml] (P ＜ 0.05).Fourteen days after surgery, the effective rate in observation group was not significantly different with that in control group [94.0％ (31/33) vs 92.6％ (25/27)] (x2 =0.36,P ＞0.05).No adverse reactions occurred in observation group;1 case had renal dysfunction and 1 case had fluid and electrolyte imbalance in control group.Conclusion There is ischemia reperfusion injury in patients with replantation of severed finger and skin flap transplantation;sodium aescinate for injection can reduce the ischemia-reperfusion injury and increase the success rate, without obvious adverse reactions.
