摘要
目的:探讨不同冲洗方法在断指再植术中的应用效果。方法:选取我院2019年6月-2020年8月收治的100例断指再植患者随机分为5组,高压冲洗组(35psi)、中压冲洗组(25psi)、低压冲洗组(15psi)、人工倾倒冲洗组、电动脉冲冲洗组,每组各20例,冲洗液均为生理盐水。术后分别采集1、3、7天的标本检测,CRP、WBC、PCT、IL-6之间的动态变化,比较5组对开放性创口早期感染敏感指标的影响,同时观察5组血管危象发生率及再植成活率。结果:5组术后分别采集1、3、7天的标本检测CRP、WBC、PCT、IL-6。其中,人工倾倒冲洗组阳性为5例,术后3天为异常结果的最高值;高压冲洗组检验结果阳性为4例,术后7天为异常结果的最高值。中压冲洗组、低压冲洗组、电动脉冲冲洗组未发现异常结果;血管危象发生率方面人工倾倒冲洗组、高压冲洗组各有6例术后发生血管危象,其中动脉危象8例,静脉危象4例,经换药、局部注射罂粟碱后7例缓解,5例坏死(人工倾倒冲洗组3例、高压冲洗组2例),人工倾倒冲洗组、高压冲洗组血管危象发生率与其它3组比较差异有统计学意义(P<0.05),人工倾倒冲洗组与高压冲洗组间比较无统计学意义(P>0.05)。结论:电动脉冲冲洗及中、低压力冲洗可有效去除污染物而不造成组织的损伤,减少术后炎症反应发生,有利于术后组织的修复,在断指再植术中的应用效果良好。
To investigate the effect of different irrigation methods in replantation of severed fingers.Methods:From June 2019 to August 2020,100 patients with replantation of severed fingers were randomly divided into two groups:high pressure washing group,medium pressure washing group,low pressure washing group(35 psi for high pressure group,25 psi for medium pressure group,15 psi for low pressure group),manual dumping washing group,and electric pulse washing group,with 20 patients in each group.The washing liquid was normal saline.Samples were collected 1,3,and 7 days after operation to detect the dynamic changes among CRP,WBC,PCT,and IL6.The effects of each group on sensitive indicators of early infection of open wounds were compared.At the same time,the incidence of vascular crisis and survival rate of replantation were observed in each group.Results:Samples were collected 1,3 and 7 days after operation in five groups to detect CRP,WBC,PCT and IL6.The abnormal rate of group A(dumping washing)was 5 cases,and the highest abnormal result was 3 days after operation;The abnormal rate of test results in group B(35 psi in high pressure group)was 4 cases,and the highest value of abnormal results was 7 days after operation.No abnormal results were found in Group C(medium pressure group 25psi),Group D(low pressure group 15psi)and Group E(electric pulse flushing group).In terms of the inci-dence rate of vascular crisis,there were 6 cases of postoperative vascular crisis in Group A and Group B,including 8 cases of arterial cri-sis and 4 cases of venous crisis,7 cases of remission and 5 cases of necrosis after drug change and local injection of papaverine(3 cases in Group A and 2 cases in Group B);The incidence of vascular crisis in Group A and Group B was significantly higher than that in the other three groups(P<0.05),and there was no significant difference between Group A and Group B(P>0.05).Conclusion:Electric pulse flushing and 15-25 psi medium and low pressure flushing can effectively remove pollutants without causing tissue
作者
罗朝晖
李木卫
LUO Chaohui;LI Muwei(Longgang orthopedics hospital of Shenzhen,Shenzhen,Guangdong 518116)
出处
《中国伤残医学》
2023年第11期15-19,共5页
Chinese Journal of Trauma and Disability Medicine
基金
深圳市龙岗区科技创新局科技计划项目(LCKCYLWS2019000820)。
关键词
可调试高压冲洗装置
脉冲
断指再植
High pressure flushing device can be debugged
Pulse washing
Replantation of severed finger
