微血管吻合器在四肢血管损伤修复的应用价值  

Application value of microvascular stapler in repair of vascular injury in extremities

作　　者：吕志刚 Lu Zhigang(Xiangyang Nurses School of Hubei Province, Xiangyang 441000, Hubei, China;Department of Surgery, Second People's Hospital, Xiangyang 441000, Hubei, China)

机构地区：[1]湖北省襄阳市护士学校,湖北襄阳441000 [2]襄阳市第二人民医院外科,湖北襄阳441000

出　　处：《血管与腔内血管外科杂志》2018年第5期390-394,398,共6页Journal of Vascular and Endovascular Surgery

摘　　要：目的探讨微血管吻合器在四肢血管损伤修复手术中的应用效果和安全性。方法选择2017年5月至2018年5月在襄阳市第二人民医院接受四肢血管血管损伤修复手术进行保肢治疗的76例患者作为研究对象,根据术中选用血管吻合方式的不同,将其分为手法缝线组(n=40)和微血管吻合器组(n=36),分别采用显微镜下手法缝线法吻合和微血管吻合器吻合。比较2组患者术中的动脉血管吻合用时、静脉血管吻合用时、缺血再灌注时间以及血管吻合后的通畅率,并观察统计2组患者的术后并发症情况。结果微血管吻合器组的动脉血管吻合用时、静脉血管吻合用时以及缺血再灌注时间均短于手法缝线组,差异均有统计学意义(P<0.05)。微血管吻合器组的血管吻合后的通畅率为100.0%高于手法缝线组的87.5%,差异有统计学意义(P<0.05)。微血管吻合器组的术后并发症发生率为5.56%,手法缝线组的术后并发症发生率为22.50%,微血管吻合器组的术后并发症发生率低于手法缝线组,差异有统计学意义(P<0.05)。结论四肢血管损伤修复手术中应用微血管吻合器进行吻合血管,吻合耗时短,能有效缩短缺血再灌注时间,减轻缺血再灌注损伤,术后并发症少,临床应用的效果和安全性良好。Objective To evaluate the efficacy and safety of microvascular stapler in repair of vascular injury in extremities. Methods From May 2017 to May 2018, 76 patients undergoing limb salvage surgery in Xiangyang second people’s Hospital were selected as study subjects. According to the different methods of vascular anastomosis, they were divided into two groups: manual suture group(n=40) and microvascular stapler group(n=36), which were anastomosed with manual suture under microscope and microvascular anastomosis with microvascular stapler respectively. The time of arterial anastomosis and the time of venous anastomosis operation, the time of ischemia reperfusion and the patency rate after vascular anastomosis between the two groups were compared. And the postoperative complications of the two groups were observed and counted. Results The arterial anastomosis time, venous anastomosis time and ischemia reperfusion time of microvascular stapler group were shorter than those of manual suture group(P<0.05). The patency rate of vascular anastomosis in microvascular stapling group was 100.0%, which was significantly higher than that in manual suture group(87.5%)(P<0.05). The incidence of postoperative complications was 5.56 in the microvascular stapler group and 22.50 in the manual suture group, the postoperative complication rate in the microvascular anastomosis group was lower than that in the manual suture group, and the difference was statistically significant(P<0.05). Conclusion Vascular anastomosis with microvascular stapler in repair of vascular injury in extremities can shorten the time of coincidence and ischemia-reperfusion, reduce the injury of ischemia and reperfusion, and reduce the complications after operation, the effect and safety of clinical application of which are good.

关 键 词：微血管吻合器 四肢 血管损伤修复 显微外科 

分 类 号：R654.3[医药卫生—外科学]