文章摘要
杨晓亮,于晓飞,刘宁.改良骨间后动脉岛状皮瓣联合复方丹参滴丸在复杂性断指再植中的效果及对凝血状况的影响.骨科,2019,10(2):115-119
改良骨间后动脉岛状皮瓣联合复方丹参滴丸在复杂性断指再植中的效果及对凝血状况的影响
Effect of modified posterior interosseous artery island flap combined with compound Danshen dripping pills on complex replantation of severed fingers and its effect on blood coagulation
投稿时间:2018-07-05  
DOI:10.3969/j.issn.1674-8573.2019.02.007
中文关键词: 骨间后动脉岛状皮瓣  复方丹参滴丸  肝素钠  凝血功能  血管危象
英文关键词: Posterior interosseous artery island flap  Compound Danshen dripping pills  Heparin sodium  Coagulation function  Vascular crisis
基金项目:
作者单位E-mail
杨晓亮 河北医科大学第三医院手外科河北石家庄 050000 d5j3l8@sina.com 
于晓飞 河北医科大学第三医院手外科河北石家庄 050000  
刘宁 河北医科大学第三医院手外科河北石家庄 050000  
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中文摘要:
      目的 研究改良骨间后动脉岛状皮瓣联合复方丹参滴丸在复杂性断指再植中的效果及对凝血状况的影响。方法 选取我院2015年5月至2016年12月期间收治的80例复杂性断指再植病人为研究对象,依据随机数字表法分为观察组和对照组,每组40例,其中对照组病人术后常规使用肝素钠进行静脉滴注,观察组病人口服复方丹参滴丸,两组病人均进行10 d的抗凝血治疗。比较两组病人间临床疗效、凝血功能以及不良反应的差异。结果 术后两组病人间临床断指成活率和术后断指血管危象发生率差异无统计学意义(χ2=0.352,P=0.556;χ2=1.051,P=0.305)。抗凝血治疗后两组病人活化部分凝血活酶时间(activated partial thromboplastin time, APTT)、血浆凝血酶原时间(prothrombin time, PT)在术后第3天均有所延长,且观察组病人的APTT、PT[(39.78±2.56) s,(24.54±0.82) s]高于对照组[(36.18±2.17) s,(19.32±1.13) s],差异有统计学意义(t=6.784,P<0.001;t=23.556,P<0.001)。而术后第10天,两组病人的APTT、PT水平明显恢复,对照组病人的APTT、PT[(34.49±2.76) s,(22.29±2.46) s]高于观察组[(30.76±2.91) s,(17.23±2.14) s](t=7.005,P<0.001;t=9.815,P<0.001)。两组病人不良反应发生率的差异无统计学意义(P均>0.05)。结论 改良骨间后动脉岛状皮瓣联合复方丹参滴丸在复杂性断指再植中的效果良好,对病人的APTT、PT影响较小,有效避免病人术后凝血功能异常,复方丹参滴丸可在一定程度上作为肝素钠的替代药物,应用于断指再植术后抗凝血治疗。
英文摘要:
      Objective To study the effect of modified posterior interosseous artery island flap combined with compound Danshen dripping pills on complex replantation of severed fingers and its effect on blood coagulation. Methods Eighty patients with complex replantation of severed fingers in our hospital from May 2015 to December 2016 were divided into observation group and control group according to random digital table, 40 cases per group. The control group was treated with heparin sodium intravenously after the operation, and the observation group was treated with compound Danshen dripping pills. The two groups were treated with 10 days. The clinical efficacy, coagulation function and adverse reactions between the two groups were compared. Results There was no significant difference in survival rate of severed fingers and postoperative crisis of severed fingers between two groups (χ2=0.352, P=0.556; χ2=1.051, P=0.305). Both activated partial thromboplastin time (APTT) and prothrombin time (PT) in the two groups were extended at third day after the operation (both P<0.05), and APTT and PT in the observation group [(39.78±2.56) s and (24.54±0.82) s] were significantly longer than those in the control group [(36.18±2.17) s and (19.32±1.13) s] (t=6.784, P<0.001; t=23.556, P<0.001). On the 10th day after operation, the APTT and PT in the two groups recovered significantly. The APTT and PT in the control group [(34.49±2.76) s and (22.29±2.46) s] were significantly longer than those in the observation group [(30.76±2.91) s and (17.23±2.14) s] (t=7.005, P<0.001; t=9.815, P<0.001). There was no significant difference between the two groups in the incidence of adverse reactions (P>0.05). Conclusion Modified modified posterior interosseous artery island flap combined with compound Danshen dripping pills is effective in complex replantation of severed fingers. It has little effect on APTT and PT and avoids the abnormal blood coagulation function of the patients post-operation. Compound Danshen dripping pills can be used as an alternative of heparin for anticoagulant therapy to a certain extent in patients after replantation of severed fingers.
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