29~31℃保温照射预防指尖离断再植及手部组织缺损静脉皮瓣修复术后血管危象的价值及其对皮瓣局部血运的影响  

The value of 29~31℃ heat preservation irradiation in preventing vascular crisis after fingertip replantation and hand tissue defect venous flap repair and its effect on local blood circulation of the flap

作　　者：李丹 刘静 窦豆 Li Dan;Liu Jing;Dou Dou(Fourth Department of Orthopedics,Luohe Orthopedic Hospital,Luohe 462300,China)

机构地区：[1]漯河市骨科医院骨四科,462300

出　　处：《国际移植与血液净化杂志》2024年第2期9-12,共4页International Journal of Transplantation and Hemopurification

摘　　要：目的探讨29~31℃保温照射预防指尖离断再植及手部组织缺损静脉皮瓣修复术后血管危象的价值及其对皮瓣局部血运的影响。方法按照计算机分组法将漯河市骨科医院骨四科2020年10月至2022年8月期间收治的111例指尖离断再植及手部组织缺损静脉皮瓣修复术后患者分为两组, 对照组55例患者给予33~35℃常规保温照射治疗, 观察组56例患者给予29~31℃保温照射治疗, 对比两组患者皮瓣、断指存活及愈合情况、血管危象发生率和皮瓣局部血运。结果两组患者平均愈合天数、感染率、皮瓣、断指存活、失活率对比差异无统计学意义(P>0.05);观察组患者血管危象发生率(10.71%)低于对照组(27.27%)(P<0.05);术后第1天、4天、7天, 观察组患者毛细血管充盈度评分、皮瓣温度、皮瓣颜色、皮瓣质地评分均低于对照组(P<0.05)。结论相较于33~35℃常规保温照射治疗指尖离断再植及手部组织缺损静脉皮瓣修复术后患者, 29~31℃保温照射更有利于改善患者皮瓣局部血运, 有效预防血管危象, 促进术后恢复, 且不增加皮瓣感染率及失活率。Objective To investigate the value of 29~31℃heat preservation irradiation in preventing vascular crisis after fingertip replantation and hand tissue defect venous flap repair,and its effect on local blood circulation of the flap.Methods According to the computer grouping method,a total of 111 patients who were treated in Fourth Department of Orthopedics,Luohe Orthopedic Hospital from October 2020 to August 2022 after finger tip replantation and hand tissue defect venous flap repair were divided into two groups.The 55 patients in the control group were treated with 33~35℃conventional thermal radiation,and the 56 patients in the observation group were treated with 29~31℃thermal radiation.The survival and healing of the flaps and severed fingers,the incidence of vascular crisis,and the local blood circulation of the flaps were compared between the two groups.Results There were no significant differences between the two groups in the average healing days,infection rate,survival and inactivation rate of flaps and severed fingers(P>0.05).The incidence of vascular crisis in the observation group patients(10.71%)was lower than that in the control group(27.27%)(P<0.05).On the 1st,4th and 7th day after the operation,the scores of capillary filling,skin flap temperature,skin flap color and skin flap texture in the observation group patients were lower than those in the control group(P<0.05).Conclusion Compared with the routine heat preservation irradiation at 33~35℃in the treatment of patients after fingertip replantation and hand tissue defect venous flap repair,29~31℃heat preservation irradiation is more conducive to improving the local blood circulation of the flap,effectively preventing vascular crisis,promoting postoperative recovery,and does not increase the infection rate and inactivation rate of the flap.

关 键 词：保温灯 温度 指尖离断再植 静脉皮瓣 血管危象 

分 类 号：R687.3[医药卫生—骨科学]