低分子肝素钙局部注射对断指再植患者D⁃D、ET⁃1及凝血功能的影响  

Effect of local injection of low molecular weight heparin calcium on D⁃D,ET⁃1 and blood coagulation function in patients with severed finger replantation

作　　者：武延朋 张永 裴敬仲 WU Yanpeng;ZHANG Yong;PEI Jingzhong(Ward 1,Burn Treatment Center,Xinxiang Second People's Hospital,Xinxiang,Henan,China,453000)

机构地区：[1]新乡市第二人民医院烧伤诊疗中心一病区,河南新乡453000

出　　处：《分子诊断与治疗杂志》2022年第12期2133-2136,2140,共5页Journal of Molecular Diagnostics and Therapy

基　　金：河南省科技攻关项目(20210230413)。

摘　　要：目的探讨低分子肝素钙局部注射治疗断指再植患者的效果及对D⁃二聚体(D⁃D)、内皮素⁃1(ET⁃1)及凝血功能的影响。方法收集2020年1月至2021年8月新乡市第二人民医院收治的92例断指再植患者的资料。按治疗方法不同分为对照组(n=44,改良骨间后动脉岛状皮瓣修复)、研究组(n=48,改良骨间后动脉岛状皮瓣修复联合低分子肝素钙局部注射)。比较两组临床疗效、D⁃D、ET⁃1、丙二醛(MDA)、超氧化物歧化酶(SOD)、凝血功能指标[凝血酶原时间(PT)、活化部分凝血酶原时间(APTT)、血浆纤维蛋白原(FIB)、凝血酶时间(TT)]及并发症。结果两组成活率、断指血管危象发生率比较差异无统计学意义(P>0.05),但研究组术后再植体周径明显短于对照组,差异有统计学意义(P<0.05)。术后,两组D⁃D、ET⁃1、MDA水平均较术前增高,SOD水平较术前下降,但研究组SOD水平明显高于对照组,D⁃D、ET⁃1、MDA水平低于对照组,差异均有统计学意义(P<0.05)。术后,两组PT、TT、APTT及FIB水平明显较术前增高,但研究组上述指标水平明显低于对照组,差异均有统计学意义(P<0.05)。研究组并发症总发生率为4.17%,对照组为9.09%,两组比较差异无统计学意义(P>0.05)。结论改良骨间后动脉岛状皮瓣修复联合低分子肝素钙局部注射治疗断指再植患者效果确切,可改善患者凝血功能,促进微循环恢复,且安全可靠。Objective To investigate the therapeutic effect of local injection of low molecular weight heparin calcium in patients with severed finger replantation and its effects on D⁃dimer(D⁃D),Endothelin⁃1(ET⁃1)and the coagulation function.Methods The data of 92 patients with severed finger replantation admitted to Xinxiang Second People's Hospital from January 2020 to August 2021 were collected.According to different treatment methods,they were divided into the control group(n=44,modified posterior interosseous artery island flap repair)and the study group(n=48,modified posterior interosseous artery island flap repair combined with local injection of low molecular weight heparin calcium).The clinical efficacy,D⁃D,ET⁃1,malondialdehyde(MDA),superoxide dismutase(SOD),coagulation function indexes[Prothrombin time(PT),Activated partial prothrombin time(APTT),Fibrinogen(FIB),Thrombin time(TT)]and complications were compared between the two groups.Results There was no difference between the two groups in terms of viability index and the incidence of severed vascular crisis(P>0.05),but the postoperative replant circumference in the study group was significantly shorter than that in the control group,and the difference was statistically significant(P<0.05).After operation,the levels of D⁃D,ET⁃1,and MDA in the two groups were increased compared with those before operation,and the level of SOD was decreased compared with that before operation,but the level of SOD in the study group was significantly higher than that in the control group,the levels of D⁃D,ET⁃1 and MDA were lower than those in the control group,and the difference was statistically significant(P<0.05).After operation,the levels of PT,TT,APTT and FIB in the two groups were significantly increase compared with those before operation,but the above indexes in the study group were significantly lower than those in the control group,and the difference was statistically significant(P<0.05).The total incidence of complications was 4.17%in the study group a

关 键 词：改良骨间后动脉岛状皮瓣术 低分子肝素钙 断肢再植 凝血功能 

分 类 号：R658.1[医药卫生—外科学]