褥式吻合在老年微血管损伤修复中的可行性及有效性分析

doi:10.3969/j.issn.1003-9198.2024.12.019

摘要/Abstract

摘要： 目的分析褥式吻合在老年微血管损伤修复中的可行性及有效性。方法选取2020年1月至2023年6月于张家港市第三人民医院行微血管损伤修复的老年断指再植病人30例,根据计算机产生的随机数列分为褥式组、传统组,每组各15例。2组均行断指再植术,褥式组采用褥式吻合,传统组采用传统间断吻合。比较2组手术时间、吻合时间、缺血再灌注时间、血管通畅率、并发症及断指功能恢复效果。结果褥式组吻合时间、缺血再灌注时间均短于传统组(P＜0.05);2组手术时间比较,差异无统计学意义(P＞0.05);术后1周,术后1、3、6个月2组血管通畅率比较,差异均无统计学意义(P＞0.05);褥式组血栓发生率低于传统组(P＜0.05),血管狭窄发生率高于传统组(P＜0.05);2组断指功能优良率比较,差异均无统计学意义(P＞0.05)。结论在老年微血管损伤修复中,褥式吻合与传统间断吻合的血管通畅率、断指功能恢复情况相当,褥式吻合的吻合时间、缺血再灌注时间更短,血栓发生率更低,传统间断吻合血管狭窄发生率更低。

关键词: 老年人, 断指再植, 微血管损伤修复, 褥式吻合, 间断吻合

Abstract: Objective To analyze the feasibility and effectiveness of mattress anastomosis in repairing microvascular injury in the elderly. Methods From January 2020 to June 2023, a total of 30 elderly patients suffering from finger replantation who were admitted to Zhangjiagang Third People’s Hospital were enrolled in this study, and were randomly divided into the mattress group and the conventional group, with 15 cases in each group. Both groups underwent finger replantation, and mattress group received mattress anastomosis and conventional group used conventional interrupted anastomosis. The operation time, anastomosis time, ischemia-reperfusion time, vascular patency rate, the incidence rate of complications and the finger function in the two groups were recorded and compared. Results The anastomosis time and ischemia-reperfusion time in the mattress group were significantly shorter than those in the conventional group (P<0.05). There were no significant differences in the operation time between the two groups (P>0.05). There were no significant differences in the vascular patency rate between the two groups 1 week, 1, 3 and 6 months after operation (P>0.05). The incidence rate of thrombosis in the mattress group was lower than that in the conventional group (P<0.05), while the incidence rate of vascular stenosis in the mattress group was higher than that in the conventional group (P<0.05). There was no significant difference in the excellent rate of finger function between the two groups (P>0.05). Conclusions In the repairing operation of microvascular injury in the elderly, mattress anastomosis and conventional interrupted anastomosis have similar vascular patency rate and finger function recovery. Mattress anastomosis could decrease the anastomosis time, ischemia-reperfusion time and thrombosis rate, while could increase the vascular stenosis rate.

Key words: aged, finger replantation, microvascular injury repair, mattress anastomosis, interrupted anastomosis

中图分类号:

R 658.1

徐克孝, 张平, 张明亮, 丁永斌, 程海. 褥式吻合在老年微血管损伤修复中的可行性及有效性分析[J]. 实用老年医学, 2024, 38(12): 1275-1279.

XU Kexiao, ZHANG Ping, ZHANG Mingliang, DING Yongbin, CHENG Hai. Feasibility and effectiveness of mattress anastomosis in repairing microvascular injury in the elderly[J]. Practical Geriatrics, 2024, 38(12): 1275-1279.

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