非洛地平联合肝素对断指再植后血管危象的预防作用及血管新生、血液流变学的影响  

Effect of Felodipine Combined with Heparin on Vascular Crisis Prevention After Finger Replantation as well as on Angiogenests and Rheology

作　　者：丁俊杰[1] 周丽娜[1] 高慧[1] 张斌杰[1] 周飞[1] 管英杰[1] 董卫东[1] 

机构地区：[1]延安市人民医院骨科,陕西延安716000

出　　处：《医学临床研究》2015年第9期1701-1704,共4页Journal of Clinical Research

摘　　要：【目的】探讨非洛地平联合肝素对断指再植后血管危象的预防作用及血管新生、血液流变学的影响。【方法】选择断指再植后患者70例，按照随机数字表法分为两组，每组35例，对照组采用常规“三抗治疗”，观察组在对照组基础上采用非洛地平联合低分子肝素钙，比较两组患者手术一般情况、血管危象发生率及治疗前后血液流变学指标变化情况；分别于术前（T0）、术后6h（T1）、12h（T2）、24h（T3）、48h（T4）、72h（T5）、120h（T6）采用流式细胞术检测两组患者外周血血管内皮生长因子（VEGF）、碱性成纤维细胞生长因子（bFGF）表达水平。【结果】两组患者手术时间比较差异无统计学意义（P〉0．05），观察组血管危象发生率8．6％（8／35）显著低于对照组28．6％（10／35），差异有统计学意义（P＜0．05）。治疗1周后两组患者全血黏度（WBV）、血浆黏度（PV）、红细胞沉降率（ESR）、血细胞比容（HCT）均显著降低，且观察组术后wBV、PV、ESR、HCT显著低于对照组（P〈0．05）。两组患者术后VEGF、bFGF表达水平开始上升，VEGF至术后48h、bFGF至术后72h表达达高峰，此后逐渐降低，至术后120hVEGF、bFGF表达仍然显著高于术前（P＜0．05）；且观察组术后各时段VEGF、bFGF表述水平显著高于同时段对照组，差异均有统计学意义（P＜0．05）。【结论】非洛地平联合肝素能够有效预防断指再植后血管危象的发生。促进植指血管新生，改善血液流变学，提高断指再植术的成功率。[Objective]To explore the effect of Felodipine combined with Heparin on vascular crisis prevention after finger replantation as well as on angiogenesis and rheology[Methods]A total of 70 cases of finger replantation patients treated in our hospital from July 2014 to July 2012 were randomly divided into the observation group 35 cases and the control group 35 cases.The control group was treated with the conventional theraoy, and the observation group was given felodipine combined with low molecular weight heparin based on those of the control group; Operation information in general , the incidence of vascular crisis and blood theological indexes before and after the treatment were observed and compared between the two groups..Flow cytometry was used to detected the expression levels of bFGF and VEGF in the peripheral blood of the two groups before（T0） and after 6h （T1）, 12h （Tz） ,24h （T3）, 48h （T4）, 72h （T5）, 120h （T6） surgery. [Results] There was no statistical difference in operation time between the two groups （ P 〉0.05）, the incidence of vascular crisis of the observation group 8.6% （8 / 35） was significantly lower than that of control group 28.6% （10 / 35）, the difference was statistically significant （P 〈 0.05 ）. 1 week after treatment, the whole blood viscosity （WBV）, plasma viscosity （PV）, red blood cell settlement rate （ESR）, blood cell hematocrit （HCT） of the two groups were significantly decreased , and the WBV, PV, ESR, HCT of the observation group after operation were significantly lower than those of the control group （ P 〈0.05）. The expression levels of bFGF and VEGF in the two groups began to increase after operation , and the expression of 48h VEGF and 72 h bFGF reached their peaks , then decreased gradually to the levels of 120h VEGF and 120h bFGF which were significantly higher than those before operation （ P 〈0.05） ; and the expression level of bFGF and VEGF was significantly higher than that of the control group. The ex

关 键 词：非洛地平/治疗应用 肝素/治疗应用 再植术 指损伤/外科学 血管疾病/病因学 

分 类 号：R658.1[医药卫生—外科学]