全程温度管理联合星状神经节阻滞对断指再植术后血管危象及断指功能恢复效果的影响  

The effect of whole process temperature management combined with stellate ganglion block on fivascular crisis and functional recovery of severed fingers after replantation surgery

作　　者：栾岩 翟新阳 刘阳[2] LUAN Yan;ZHAI Xinyang;LIU Yang(Department of Pediatric Surgery,Nanyang Central Hospital,Henan Province,473000,China;Emergency department of Pediatrics,Nanshi Hospital,Henan Province,473000,China)

机构地区：[1]南阳市中心医院儿童外科,河南南阳473000 [2]急诊儿科,南阳市中心医院急诊儿科,河南南阳473000

出　　处：《中国医疗美容》2024年第11期55-59,共5页China Medical Cosmetology

摘　　要：目的观察全程温度管理联合星状神经节阻滞干预在断指再植术患者中的应用效果。方法选取2021年2月至2024年6月于南阳市中心医院实施断指再植术的患者,按治疗方法不同分为观察组和对照组,每组51例。两组患者均在臂丛神经阻滞麻醉下顺利实施断指再植术,对照组患者术后72 h内实施在超声引导下的连续星状神经节阻滞,观察组患者在对照组基础上给予全程温度管理干预。比较两组患者术后即刻、1 h、3 h、24 h、72 h时患指侧前臂掌心温度、血流灌注指数、疼痛评分,以及血管危象发生率和断指功能恢复情况。结果两组患者术后即刻患指侧前臂掌心温度、血流灌注指数、疼痛评分组间比较,差异均无统计学意义(P>0.05),观察组术后1 h、3 h、24 h、72 h患侧前臂掌心温度和血流灌注指数均高于对照组(P<0.05),且疼痛评分低于对照组(P<0.05)。观察组患者血管危象发生率低于对照组,组间比较差异有统计学意义(χ^(2)=4.387,P=0.036);观察组患者断指功能恢复优良率高于对照组,组间比较差异有统计学意义(χ^(2)=3.991,P=0.045)。结论全程温度管理联合星状神经节阻滞可有效提升断指再植术后患指血流灌注量,缓解术后疼痛,避免术后血管危象发生,且对提升患指功能恢复优良率具有良好效果。Objective Observation of the application effect of whole process temperature management combined with stellate ganglion block intervention in patients undergoing fifinger replantation surgery.Methods The research data was collected from February 2021 to June 2024,and the study subjects were patients who underwent fifinger replantation surgery in our hospital.The study subjects were randomly divided into an observation group and a control group using a random number table method.Both groups of patients successfully underwent fifinger replantation surgery under brachial plexus block anesthesia.The control group underwent continuous stellate ganglion block under ultrasound guidance within 72 hours after surgery,and the observation group received full temperature management intervention on the basis of the control group.Compare the temperature,blood perfusion index,pain score,incidence of vascular crisis,and recovery of severed fifinger function of the affected forearm palm between two groups of patients immediately,1 h,3 h,24 h,and 72 h after surgery.Results There was no statistically signifificant difference in the temperature,blood flflow perfusion index,and pain score of the affected forearm palm between the two groups of patients immediately after surgery(P>0.05).The temperature and blood flflow perfusion index of the affected forearm palm in the observation group were higher than those in the control group at 1 h,3 h,24 h,and 72 h after surgery(P<0.05),and the pain score was lower than that in the control group(P<0.05).The incidence of vascular crisis in the observation group was lower than that in the control group,and the difference between the groups was statistically significant(χ^(2)=4.387,P=0.036).The excellent recovery rate of severed finger function in the observation group was higher than that in the control group,and the difference between the groups was statistically signifificant(χ^(2)=3.991,P=0.045).Conclusions The combination of full temperature management and stellate ganglion block can effecti

关 键 词：断指再植 温度管理 星状神经节阻滞 血流灌注 血管危象 功能恢复 

分 类 号：R473.6[医药卫生—护理学]