应用显微外科技术治疗手部高压注射伤的临床研究  

A clinical study on the application of microsurgical techniques in the treatment of high-pressure injection injuries of the hand

作　　者：朱东亮 邵帅 张景哲 ZHU Dongliang;SHAO Shuai;ZHANG Jingzhe(The Third Department of Hand and Foot Surgery,Zhoukou Huaihai Hospital,Zhoukou,Henan 466700,China)

机构地区：[1]周口淮海医院手足外三科,河南周口466700

出　　处：《检验医学与临床》2023年第10期1443-1446,共4页Laboratory Medicine and Clinic

摘　　要：目的分析应用显微外科技术治疗手部高压注射伤(HPIIH)患者的效果。方法收集该院2020年1月至2022年3月80例HPIIH患者为研究对象,按手术方案不同分成A组、B组,每组各40例。B组在肉眼下实施清创治疗,A组在显微外科技术下实施清创治疗。比较两组手指总体主动活动度(TAM)恢复情况、创面恢复指标、手术前后TAM变化、血清成纤维细胞生长因子(bFGF)、人表皮生长因子(EGF)、转化生长因子-β1(TGF-β1)水平,以及并发症总发生率。结果A组与B组优良率分别为95.00%、77.50%,A组明显高于B组,差异有统计学意义(χ^(2)=5.165,P=0.023)。与B组比较,A组创面愈合时间、创面血液循环恢复时间更短,创面愈合率更高,差异有统计学意义(P<0.05)。与术前比较,术后1、3个月两组TAM及bFGF、EGF、TGF-β1水平均明显升高,其中A组升高幅度更明显,术后1、3个月A组4项指标明显高于B组,差异有统计学意义(P<0.05)。A组与B组并发症总发生率分别为5.00%、22.50%,A组明显低于B组,差异有统计学意义(χ^(2)=5.000,P=0.024)。结论与传统肉眼清创治疗HPIIH相比,应用显微外科技术实施清创治疗更有助于提升手术效果,优化创面恢复指标,调节相关血清生化因子表达,促进创面愈合及手部功能恢复。Objective To investigate the effect of microsurgical techniques in the treatment of patients with high pressure injection injury of hand(HPIIH).Methods A total of 80 patients with HPIIH in this hospital from January 2020 to March 2022 were collected as research objects and divided into group A and group B according to different surgical plans,with 40 patients in each group.Group B was treated with debridement under the naked eye,and group A was treated with debridement under the microsurgical technique.The recovery of the overall active range of motion of fingers(TAM),wound recovery indicators,TAM before and after surgery,serum fibroblast growth factor(bFGF),human epidermal growth factor(EGF),transforming growth factor-β1(TGF-β1)level,total incidence of complications were compared between the two groups.Results The excellent and good rates of group A and group B were 95.00%and 77.50%respectively,which in group A was significant higher than that in group B(χ^(2)=5.165,P=0.023).Compared with those in group B,the wound healing time and wound blood circulation recovery time in group A were shorter,and the wound healing rate was higher,the differences were statistical significance(P<0.05).Compared with the preoperative level,the TAM and the levels of bFGF,EGF,TGF-β1 in both groups increased significantly at 1 and 3 months after surgery,and the increase was more obvious in group A,which was significantly higher than that in group B at 1 and 3 months after surgery,the differences were statistically significant(P<0.05).The total incidence of complications in group A and group B were 5.00%and 22.50%respectively,group A was significantly lower than group B,the difference was statistically significant(χ^(2)=5.000,P=0.024).Conclusion Compared with the traditional macroscopic debridement for HPIIH,the application of microsurgical debridement is more helpful to improve the surgical effect,optimize the wound recovery index,regulate the expression of serum-related biochemical factors,and promote wound healing and hand funct

关 键 词：手部高压注射伤 人表皮生长因子 显微外科技术 清创 并发症 

分 类 号：R658.2[医药卫生—外科学]