显微镜下断指再植术在末节手指离断中的应用效果分析  

Analysis of the application effect of replantation of severed finger under microscope on severed finger in patients with distal finger amputation

作　　者：祝光瑞 Zhu Guang-rui(Emergency Trauma Center,Yushan County People’s Hospital,Shangrao 334600,Jiangxi,China)

机构地区：[1]上饶市玉山县人民医院急诊创伤中心,江西上饶334600

出　　处：《四川生理科学杂志》2025年第1期74-76,共3页

摘　　要：目的:探究显微镜下断指再植术在末节手指离断患者中的应用效果,分析对其血流循环和应激反应的影响。方法:选择2018年1月至2023年12月间收治的末节手指离断患者60例,依据手术方式不同,将采用常规断指再植术治疗的21例为常规组,采用显微镜下断指再植术的39例为研究组。比较两组治疗效果、断指恢复情况、断指血液循环和应激反应,随访并发症情况。结果:治疗后,研究组治疗总有效率、断指指甲长度和远端关节活动度高于常规组(P<0.05),两点分辨觉低于常规组(P<0.05);治疗后第4 w、12 w,研究组断指动脉血流速度和温度高于常规组(P<0.05),血流阻力指数低于常规组(P<0.05);治疗后第1 d、第5 d,研究组皮质醇(cortisol,Cor)、肾上腺素(epinephrine,E)、多巴胺(dopamine,DA)和β内啡肽水平低于常规组(P<0.05);研究组并发症发生率低于常规组(P<0.05)。结论:显微镜下断指再植术在末节手指离断患者治疗中效果确切,可促进断指功能恢复,改善断指血液循环及应激反应,减少术后并发症。Objective:To explore the effect of replantation of severed finger under microscope in patients with distal finger amputation,and analyze the impact on severed finger blood circulation stress response.Methods:From January 2018 to December 2023,60 patients with distal finger amputation were selected.According to different surgical methods,21 patients treated with conventional replantation of severed finger were enrolled as conventional group,and 39 patients who received replantation of severed finger under microscope were included in study group.The therapeutic effect,severed finger recovery status,severed finger blood circulation and stress response and follow-up complications were compared between groups.Results:After treatment,the total effective rate of treatment,nail length of severed finger and distal joint mobility in study group were higher than those in conventional group(P<0.05),while the two-point discrimination was lower than that in conventional group(P<0.05).On the 4th and 12th weeks after treatment,the severed finger artery blood flow velocity and temperature in study group were higher(P<0.05)while the blood flow resistance index was lower compared to conventional group(P<0.05).On the 1st day and 5th day after treatment,the levels of cortisol(Cor),epinephrine(E),dopamine(DA)andβ-endorphin were lower in study group than those in conventional group(P<0.05).The incidence rates of complications in study group were lower than those in conventional group(P<0.05).Conclusion:Replantation of severed finger under microscope has an exact efficacy in the treatment of patients with distal finger amputation,and it can promote the recovery of severed finger function,improve the severed finger blood circulation and stress response,and reduce the postoperative complications.

关 键 词：末节手指离断 显微镜 断指再植术 应用效果 指血液循环 应激反应 

分 类 号：R65[医药卫生—外科学]