前列地尔在断指再植中的临床应用研究Clinical Application of Alprostadil in Replantation of Amputated Fingers
古小玲,古汉南,陈瑶,李木卫,张子清
GU Xiaoling,GU Hannan,CHEN Yao,LI Muwei,ZHANG Ziqing
摘要(Abstract):
目的探讨前列地尔在断指再植术后预防血管危象的临床疗效。方法收集本院2014-01~2015-03期间60例断指再植术后患者,随机等分为2组,除基础治疗外,实验组使用罂粟碱+前列地尔,对照组使用罂粟碱+肝素,观察术后1周2组管危象发生的情况,毛细血管反应情况,术后1周的完全存活率等指标。结果实验组术后再植指体29例存活良好,1例坏死,存活率96.7%。对照组术后再植指体28例存活良好,2例发生坏死,存活率93.3%。2组之间无显著性差异(P>0.05)。结论前列地尔脂微球制剂能有效地防止断指再植术后血管危象的发生,提高再植指体的成活率。
OBJECTIVE To investigate the clinical effect of Alprostadil in prevention of vascular crisis after replantation of amputated fingers. METHODS A total of 60 cases with replantation of amputated fingers from January to March in 2014 in the hospital were divided into experimental group and control group randomly. Besides basic treatment for all cases,Papaverine and Alprostadil were used in experimental group while Papaverine and Heparin were used in the control group,and during one week after the surgery,occurrence of vascular crisis,capillary reaction,completely survival rate of replanted fingers were observed.RESULTS There were 29 survival cases in the experimental group,and necrosis only happened in 1 case,therefore the survival rate was 96.7%. In the control group,there were 28 cases survived,and necrosis happened in 2 cases,therefore the survival rate was 93.3%. There was no significant difference between the 2 groups( P>0.05). CONCLUSION Alprostadil of lipid microsphere preparation can effectively prevent the occurrence of vascular crisis after replantation of amputated fingers and improve the survival rate of replanted fingers.
关键词(KeyWords):
前列地尔;肝素;断指再植;血管危象;成活率
alprostadil;heparin;finger replantation;vascular crisis;survival rate
基金项目(Foundation):
作者(Author):
古小玲,古汉南,陈瑶,李木卫,张子清
GU Xiaoling,GU Hannan,CHEN Yao,LI Muwei,ZHANG Ziqing
参考文献(References):
- [1]宋开芳,陈艺新,陈克洲.指腹皮下肝素浸润预防断指再植术后血管危象[J].中华显微外科杂志,2002,25(3):224-225.
- [2]牟怡平,张扬,辛畅泰.断指再植术后肝素抗凝治疗的风险评估[J].医学与哲学,2013,34(10):42-44.
- [3]胡瑞明.低分子肝素在断指再植术后抗凝治疗中的应用[J].基层医学论坛,2013(17):2275.
- [4]陶永,吴友利.断指再植的经验与体会[J].中国医学创新,2010,7(5):162-163.
- [5]施洪臣,李宝山,章雪松.肝素在临床上的应用[J].临床军医杂志,2003,31(2):100-101.
- [6]刘颖,郑立运.前列地尔骨科临床应用研究进展[J].中国药师杂志,2013,16(7):1071-1073.
- [7]周如君,武英.前列地尔的剂型及临床研究进展[J].中国煤炭工业医学杂志,2014,17(11):1883-1887.
- [8]Kurokuwa R,Nagayama E,Murata H,et al.limaprost alfadex,a prostaglandin E1 derivative,prevents deterioration of fored exercise capability in rats with chronic compression of the spinal cord[J].spine,2011,36:865-869.
- [9]谭旭昌,刘景臣.前列腺素E1在断指再植术后的临床应用[J].中国实用医药,2009,4(2):55-57.
- [10]戎晓敏,李俊.凯时用于断指再植术后血管危象防治的临床研究[J].医药前沿,2014(6):115-117.
- [11]李静宜,李强,王薇.前列地尔脂微球载体注射液对糖尿病下肢动脉血管病变的影响[J].中国实用内科杂志,2007,27(8):597-599.
- [12]张宇浩,陈婕,马昱.凯时在椎基底动脉供血不足治疗中的应用[J].中国临床医学,2002,9(6):726-728.
- [13]陈修.心血管药理学[M].北京:人民卫生出版社,2002:125.