中剂量肝素疗法在指尖离断中的应用  

Clinical application of moderate dose h eparin in replantation of amputated fingertip

作　　者：潘希贵[1] 田万成[1] 卢全中[1] 管同勋[1] 

机构地区：[1]中国人民解放军第107医院手外科,山东烟台264002

出　　处：《实用手外科杂志》2003年第1期17-18,共2页Journal of Practical Hand Surgery

摘　　要：目的探讨中剂量肝素疗法在指尖离断再植时的应用。方法临床应用生理盐水500ml+肝素100mg(12500单位)持续静脉滴注,维持24h(滴数为每分钟6滴),应用肝素后定时采用光照凝块探测技术测定活化部分凝血时间(APTT)及观察皮缘渗血情况,并与随机取20例采用常规抗凝治疗断指再植病人进行比较。结果本组65例72指,成活67指,成活率94%。经6～24月随访,手指外形和长度与健指相似,两点辨别觉2mm～6mm。结论在不增加出血倾向的前提下,中剂量肝素能有效延长凝血时间,提高指尖离断再植成活率,在临床应用是安全有效的。Objective To discuss the clinical evaluation of moderatedos e heparin in replantation of amputated fingertip.Methods Sixty-fivecases with fin gertip amputated were replanted with contin-uous venoclysis physiological saline 500ml+heparin100mg(12500u,100mg/d),after using heparin APTT and skin bleeding we re randomlymeasuredon time in20cases.Results Sixty-fivecases(72fingers)received replantation,67fingertip survived with satisfactory appearanceand2-PDwas3～6mm,t he survival rate was94%.Conclusion Withoutincreasing the hemorrhagetendency,mode ratedose heparin can effectively prolong APTTand raise survival rate in replanta tion of fingertip.It is safe and ef-fective in clinical application.

关 键 词：肝素 指尖损伤 断离再植术 显微外科 

分 类 号：R658.2[医药卫生—外科学] R973.2[医药卫生—临床医学]