罂粟碱联合低分子右旋糖酐在断指再植中的应用价值及对血管危象、血液流变学指标的影响  

Application value of papaverine combined with low molecular dextran in replantation of severed fingers and its influences on vascular crisis and hemorheological indexes

作　　者：苏杭 沈君高 SU Hang;SHEN Jungao(Qujiang Kaixuanmen Community Health Service Station,Yanta District,Xi'an 710000;the First People's Hospital of Xianyang,Xianyang 712099,China)

机构地区：[1]西安市雁塔区曲江凯旋门社区卫生服务站,陕西西安710000 [2]咸阳市第一人民医院,陕西咸阳712099

出　　处：《临床医学研究与实践》2023年第15期99-102,共4页Clinical Research and Practice

摘　　要：目的探讨罂粟碱联合低分子右旋糖酐在断指再植中的应用价值。方法选取2019年5月至2020年5月于本院接受治疗的60例(84指)断指再植患者作为研究对象,按照治疗方案的不同将其分为对照组(30例,41指,断指再植术+罂粟碱)和观察组(30例,43指,断指再植术+罂粟碱+低分子右旋糖酐)。比较两组的断指再植成活率、血管危象发生率、内皮素-1(ET-1)、降钙素基因相关肽(CGRP)水平、血管危象指标、血液流变学指标和并发症发生情况。结果观察组的断指再植成活率明显高于对照组,血管危象总发生率明显低于对照组,差异具有统计学意义(P<0.05)。术后第7天,观察组的ET-1水平明显低于对照组,CGRP水平明显高于对照组,差异具有统计学意义(P<0.05)。术后第7天,观察组的阻力指数(RI)、搏动指数(PI)明显低于对照组,平均血流速度(Vm)明显高于对照组,差异具有统计学意义(P<0.05)。术后第7天,观察组的红细胞压积、血浆黏度、全血高切黏度明显低于对照组,差异具有统计学意义(P<0.05)。观察组的并发症总发生率明显低于对照组,差异具有统计学意义(P<0.05)。结论罂粟碱联合低分子右旋糖酐在断指再植中的应用价值显著,可提高再植成活率,调节各项血管危象指标,改善血液流变学指标,降低并发症发生率。Objective To explore the application value of papaverine combined with low molecular dextran in replantation of severed fingers.Methods A total of 60 patients(84 fingers)with replantation of severed fingers who were treated in our hospital from May 2019 to May 2020 were selected as the research objects.According to different treatment schemes,the patients were divided into control group(30 cases,41 fingers,replantation of severed fingers+papaverine)and observation group(30 cases,43 fingers,replantation of severed fingers+papaverine+low molecular dextran).The survival rate of replantation of severed fingers,the incidence of vascular crisis,the levels of endothelin-1(ET-1),calcitonin gene related peptide(CGRP),vascular crisis indexes,hemorheology indexes and incidence of complications were compared between the two groups.Results The survival rate of replantation of severed fingers in the observation group was significantly higher than that in the control group,the total incidence of vascular crisis was significantly lower than that in the control group,and the differences were statistically significant(P<0.05).On the 7th day after operation,the ET-1 level in the observation group was significantly lower than that in the control group,the CGRP level was significantly higher than that in the control group,and the differences were statistically significant(P<0.05).On the 7th day after operation,the resistance index(RI)and pulsatility index(PI)of the observation group were significantly lower than those of the control group,the mean blood flow velocity(Vm)was significantly higher than that of the control group,and the differences were statistically significant(P<0.05).On the 7th day after operation,hematocrit,plasma viscosity and whole blood high shear viscosity in the observation group were significantly lower than those in the control group,and the differences were statistically significant(P<0.05).The total incidence of complications in the observation group was significantly lower than that in the control group,and

关 键 词：断指再植术 罂粟碱 低分子右旋糖酐 血管危象 血液流变学 

分 类 号：R658.1[医药卫生—外科学]