改良血管套接法与血管断端吻合法对断指再植患者断指血运、断指成活以及运动功能的影响

目的:探讨改良血管套接法与血管断端吻合法对断指再植患者断指血运、断指成活以及运动功能的影响。方法:回顾性分析我院于2017年1月到2018年12月期间治疗的107例断指再植患者的临床资料。根据手术方法的不同将患者分为A组(n=55,共断指93指)和B组(n=52,共断指86指),A组给予血管断端吻合法,B组给予改良血管套接法,比较两组患者断指血运、断指成活、运动功能、生活质量及并发症。结果:B组毛细血管充盈时间、患指微循环检测值低于A组,氧饱和度、经皮氧分压则高于A组(P<0.05)。B组断指成活率、断指张力正常率及断指颜色正常率均高于A组(P<0.05)。B组术后1年社会关系领域、生理领域、心理领域以及环境领域的维度评分均高于A组(P<0.05)。B组的肌力、活动度、灵巧度、Carroll量表评分均高于A组(P<0.05)。两组并发症发生率对比未见统计学差异(P>0.05)。结论:与血管断端吻合法相比,断指再植患者采用改良血管套接法,在断指血运、断指成活、运动功能、生活质量方面的改善效果更佳,且不会增加并发症发生率。

The Influence of Improved Vascular Intubation and End to End Vascular Anastomosis on the Blood Circulation, Survival and Motor Function of Severed Fingers in Patients with Replantation of Severed Fingers

ABSTRACT Objective: To investigate the influence of the improved vascular intubation and the end to end vascular anastomosis on the blood circulation, survival and motor function of severed fingers in patients with replantation. Methods: The clinical data of 107 cases of patients with replantation of severed fingers who were treated in our hospital from January 2017 to December 2018 were retrospectively selected. According to the different operative methods, the patients were divided into group A (n=55, 93 severed fingers in total) and group B (n=52, 86 severed fingers in total). Group A was treated with end to end vascular anastomosis, and group B was treated with improved vascular intubation. The blood circulation, survival, motor function, quality of life and complications of the two groups were compared. Results: The filling time of capillaries and microcirculation of the affected fingers test value in group B were lower than those in group A, while the oxygen saturation and transcutaneous oxygen partial pressure were higher than those in group A (P<0.05). The survival rate, normal tension rate and normal color rate of severed fingers in group B were higher than those in group A (P<0.05). The scores of physiological field, social relationship field, psychological field and environmental field in group B at 1 year after operation were higher than those in group A (P<0.05). The scores of activity, muscle strength, dexterity and Carroll scale in group B were higher than those in group A (P<0.05). There were no significant differences in the incidence of complications between the two groups (P>0.05). Conclusion: Compared with the method of end to end vascular anastomosis, improved vascular intubation for replantation of severed fingers, it the improvement effect is better in the aspects of blood circulation, survival, motor function and quality of life of severed fingers, and will not increase the incidence of complications.