Research on the Influence of Three Postoperative Analgesia Methods on the Survival Rate of Replanted Finger by Flat Digital Subtraction Angiography_West China Medical Journal

Authors：

 WangWenjie ¹ , PengJixia ² , ChenHongying ¹ , LiYing ¹ , LiXianyu ² ,  ChenDesen ²

1. Nursing Department, Shiyan Taihe Hospital(the Affiliated Hospital of Hubei Medical College), Shiyan, Hubei 442000, P. R. China;
2. Function Laboratory, Hubei Medical College, Shiyan, Hubei 442000, P. R. China;

Corresponding?author：

ChenDesen, Email: cdscds1226@126.com

Keywords：

Flat digital subtraction angiography; Replantation surgery; Pain; Vascular crisis; Survival

DOI：

10.7507/1002-0179.201600147

Video：

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Objective To observe the influence of three postoperative analgesia methods on the survival rate of replanted finger by flat digital subtraction angiography (DSA) medical imaging detection system. Method From July 2014 to July 2015, 342 patients were classified into gradeⅠ and gradeⅡ replantation in accordance with their physical condition and they were randomly divided into routine oral group, muscle injection group and analgesia group with 144 patients in each. Flat DSA was used to dynamically observe replantation after revascularization. Then we compared the three different analgesia methods in terms of psychological status of the patients, incidence of vascular crisis, occlusion rate, survival rate of replanted fingers. The function score of replanted fingers was evaluated for clinical efficacy. Results Compared with the conventional oral group and muscle injection group, the incidence of vascular crisis in replanted fingers and thrombosis rate were significantly lower in the analgesia group which had a replanted finger survival rate of 96.69% and a normal mental condition rate of 78.07%. Six months after surgery, the rate of excellent and good follow-up was significantly higher than the conventional oral group and muscle injection group (P<0.017) . Conclusions The 3-D technology of flat DSA can provide clear and reliable pictures of vessel revascularization status for replanted fingers. The use of continuous brachial plexus analgesia performs better than other methods of analgesia. Good analgesia can stabilize patients' anxiety and negative emotions, which is helpful to avoid excessive fluctuations in blood pressure induced by small artery spasm caused by blood clots and vascular crisis, thereby increasing the survival rate of replanted fingers and facilitating early rehabilitation of their function.

Citation： WangWenjie, PengJixia, ChenHongying, LiYing, LiXianyu, ChenDesen. Research on the Influence of Three Postoperative Analgesia Methods on the Survival Rate of Replanted Finger by Flat Digital Subtraction Angiography. West China Medical Journal, 2016, 31(3): 556-559. doi: 10.7507/1002-0179.201600147 Copy

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17.	許培紅, 彭文勇, 蔡秋瑾. 連續臂叢阻滯鎮痛對斷指再植成活率的影響[J]. 全科醫學臨床與教育, 2010, 8(4) :397-399.
18.	黃河, 李國棟, 肖炳祥, 等. 基于平板DSA數據的神經導航輔助下腦動靜脈畸形合并靜脈瘤手術1例[J]. 中國臨床神經外科雜志, 2014, 26(1) :46-47.

1. 程國良. 手指再植與再造[M]. 2版. 北京:人民衛生出版社, 2005:81-116.
2. 劉川, 吳繼生, 王杰, 等. 末梢灌注指數在斷指再植術后血管危象診斷中的價值[J]. 華西醫學, 2012, 27(5) :670-672.
3. 王紅, 晁明, 蔣定堯, 等. DSA在斷指再植血管評價中的價值[J]. 中華放射學雜志, 2008, 42(2) :189-191.
4. 修平, 李政平, 徐林. 外傷斷指后不良心理狀態對斷指再植成活率的影響[J]. 中國心理衛生雜志, 2005, 19(2) :100-101.
5. 呂青, 王愛蘭, 丁自海, 等. 現代創傷顯微外科護理學[M]. 北京:人民軍醫出版社, 2001:173.
6. 潘生德, 顧玉東, 侍德. 中華醫學會手外科學會上肢部分功能評定試用標準[J]. 中華手外科雜志, 2000, 16(3) :130.
7. 宋艷麗, 郭俐宏, 陳德森. 護理干預對斷指再植存活及功能恢復的相關性研究[J]. 護士進修雜志, 2013, 28(16) :1492-1494.
8. 倪嬌, 王占忠, 姜涌. 干預對降低斷指再植術后血管危象發生的作用[J]. 河北醫學, 2013, 19(12) :1904-1906.
9. 劉寧富, 楊紹安, 李松建, 等. 斷指再植的臨床經驗與體會[J]. 中華顯微外科雜志, 2003, 26(2) :138-139.
10. 彭婷. 綜合心理護理對斷指再植病人心理狀態和再植指功能康復的影響[J]. 全科護理, 2010, 8(19) :1732-1733.
11. 王海平. 彩色多普勒高頻超聲對腘窩滑膜囊腫的診斷價值[J]. 華西醫學, 2014, 29(4) :734-735.
12. 李信友, 曾勇明, 陸云峰, 等. 平板探測器DSA冠狀動脈造影的臨床應用及評價[J]. 實用醫學影像雜志, 2005, 6(6) :304-306.
13. 張定寶, 肖介川, 高坤華, 等. 斷指再植術后彩色多普勒血流與再植指血液循環狀況相關性研究[J]. 中國現代醫生, 2013, 51(9) :102-103, 105.
14. 徐力揚, 李京雨, 張強, 等. 旋轉DSA及三維重建技術在腦血管造影中的應用[J]. 中國醫學影像技術, 2003, 19(10) :1377-1379.
15. 顧玉東, 王澍寰. 手外科學[M]. 上海:復旦大學出版社, 2003:603.
16. 陳宏, 章偉文, 李學淵. 斷指再植術后動脈危象的處理[J]. 中華手外科雜志, 1999, 15(4) :238.
17. 許培紅, 彭文勇, 蔡秋瑾. 連續臂叢阻滯鎮痛對斷指再植成活率的影響[J]. 全科醫學臨床與教育, 2010, 8(4) :397-399.
18. 黃河, 李國棟, 肖炳祥, 等. 基于平板DSA數據的神經導航輔助下腦動靜脈畸形合并靜脈瘤手術1例[J]. 中國臨床神經外科雜志, 2014, 26(1) :46-47.

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Research on the Influence of Three Postoperative Analgesia Methods on the Survival Rate of Replanted Finger by Flat Digital Subtraction Angiography

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