Analysis of the cause and prevention of vascular crisis in finger replantation
10.3760/cma.j.issn.1008-6706.2019.19.002
- VernacularTitle: 断指再植术发生血管危象的原因分析及防治心得
- Author:
Feipeng CHEN
1
Author Information
1. Department of Hand Surgery, the First People's Hospital of Yongkang, Yongkang, Zhejiang 321300, China
- Publication Type:Journal Article
- Keywords:
Replantation;
Drug therapy;
Dextrans;
Thrombin;
Protective agents
- From:
Chinese Journal of Primary Medicine and Pharmacy
2019;26(19):2310-2313
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the causes of vascular crisis caused by replantation of severed finger, and summarize the experience of prevention and treatment.
Methods:From April 2015 to February 2017, 108 patients with wounded finger treated in the First People's Hospital of Yongkang were divided into two groups according to the occurrence of postoperative vascular crisis situation: the control group (56 cases, vascular risk), the observation group (52 cases, vascular crisis happened). The clinical data of all patients were collected, the various data were compared, and the causes of vascular crisis were analyzed.The observation group was given low molecular dextran treatment, the changes of blood coagulation function indicators before and after treatment were observed.
Results:The age, disconnection plane, ischemia time had statistically significant differences between the two groups(all P<0.05). After treatment, the four coagulation function index in the observation group [fiber protease: (3.32±0.29)g/L, activated partial thrombin time: (27.56±2.08)s, thrombin time: (12.13±1.62)s, prothrombin time: (11.47±1.29)s] were improved obviously (t=4.86, 8.63, 6.04, 4.70, all P<0.05).
Conclusion:The age, disconnection plane and ischemic time are the factors that cause vascular crisis.In addition, postoperative pain, patients' mood, postoperative posture and other factors may also lead to vascular crisis.Preoperative assessment of the condition should be done well, postoperative monitoring should be strengthened, and prophylactic medication can be used to prevent vascular crisis.
