手指离断患者断指再植术后再植指功能恢复差的高危因素分析  

Analysis of high risk factors for poor functional recovery of replanted fingers after replantation of severed fingers

作　　者：施明宏 程建和 张炬云 赵敏 SHI Minghong;CHENG Jianhe;ZHANG Juyun;ZHAO Min(Department of Orthopaedics,Yingtan Medical District,908 Hospital of Joint Service Support Force of People's Liberation Army of China,Yingtan,Jiangxi,335000,China;Department of Orthopaedics,Yingtan 184 Hospital,Yingtan,Jiangxi,335000,China;Department of Orthopaedics,Jingdezhen Changjiang Hospital,Jingdezhen,Jiangxi,333000,China;Yingtan Municipal Health Commission,Yingtan,Jiangxi,335000,China)

机构地区：[1]中国人民解放军联勤保障部队第908医院鹰潭医疗区骨科,江西鹰潭335000 [2]鹰潭一八四医院骨科,江西鹰潭335000 [3]景德镇昌江医院骨科,江西景德镇333000 [4]鹰潭市卫健委,江西鹰潭335000

出　　处：《当代医学》2024年第24期151-155,共5页Contemporary Medicine

基　　金：江西省卫生健康委科技计划(202311385)。

摘　　要：目的探讨断指再植手术治疗手指离断的临床效果及再植指功能恢复差的危险因素。方法选取2020年1月至2022年1月于中国人民解放军联勤保障部队第908医院鹰潭医疗区骨科行断指再植手术治疗的100例手指离断患者作为研究对象,分析断指再植手术治疗效果,采用单因素及多因素Logistic回归分析再植指功能恢复差的危险因素。结果再植指功能恢复效果优57例,良32例,差11例,优良率为89.00%。单因素分析结果显示,不同断指再植指功能恢复效果患者年龄、性别、文化程度、费用支付方式、职业、离断平面、暴露时间、关节面损伤、损伤手指、植皮、肌腱粘连比较差异无统计学意义;不同断指再植指功能恢复效果患者损伤性质、离断程度、术后焦虑、术后抑郁、手术次数、断指保存方式比较差异有统计学意义(P<0.05)。多因素Logistic回归分析结果显示,手指离断患者损伤性质为切割伤、完全离断、术后焦虑、术后抑郁、手术次数≥3次、断指常温保存是手指离断患者术后再植指功能恢复效果差的危险因素(P<0.05)。结论影响断指再植术后指功能恢复的危险因素较多,需及时采取科学的防治策略,以提高再植指功能恢复效果。Objective To investigate the clinical effect of replantation of severed fingers and the risk factors of poor functional recovery of replanted fingers.Methods 100 patients with severed fingers who underwent replantation surgery in the department of orthopaedics of Yingtan Medical District,908 Hospital of Joint Support Force of People's Liberation Army of China from January 2020 to January 2022 were selected as the study subjects,the effect of replantation of severed fingers was analyzed,and the risk factors of poor functional recovery of replantation finger were analyzed by univariate and multivariate Logistic regression.Results The functional recovery of replantation fingers was excellent in 57 cases,good in 32 cases,and poor in 11 cases,and the excellent and good rate was 89.00%.The results of univariate analysis showed that there was no statistically significant difference in age,gender,education level,payment method,occupation,detachment plane,exposure time,joint surface injury,injured finger,skin graft,and tendon adhesion among patients with different finger replantation functional recovery effects;there were statistically significant differences in the nature of injury,degree of amputation,postoperative anxiety,postoperative depression,number of surgeries,and method of finger preservation among patients with different outcomes of finger replantation(P<0.05).The results of multivariate Logistic regression analysis showed that cutting injury,complete amputation,postoperative anxiety,postoperative depression,number of surgeries≥3,and preservation of severed fingers at room temperature were risk factors for poor functional recovery of replantation of severed fingers in patients with severed fingers(P<0.05).Conclusion There are many risk factors affecting the functional recovery of fingers after replantation of severed fingers,scientific prevention and treatment strategies should be taken in time to improve the poor functional recovery effect of replanted fingers.

关 键 词：断指再植手术 手指离断 再植指功能 恢复效果 高危因素 

分 类 号：R65[医药卫生—外科学]