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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Abstract Full text Figures/Tables Video References Cited by

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.	许培红, 彭文勇, 蔡秋瑾. 连续臂丛阻滞镇痛对断指再植成活率的影响[J]. 全科医学临床与教育, 2010, 8(4) :397-399.
18.	黄河, 李国栋, 肖炳祥, 等. 基于平板DSA数据的神经导航辅助下脑动静脉畸形合并静脉瘤手术1例[J]. 中国临床神经外科杂志, 2014, 26(1) :46-47.

1. 程国良. 手指再植与再造[M]. 2版. 北京:人民卫生出版社, 2005:81-116.
2. 刘川, 吴继生, 王杰, 等. 末梢灌注指数在断指再植术后血管危象诊断中的价值[J]. 华西医学, 2012, 27(5) :670-672.
3. 王红, 晁明, 蒋定尧, 等. DSA在断指再植血管评价中的价值[J]. 中华放射学杂志, 2008, 42(2) :189-191.
4. 修平, 李政平, 徐林. 外伤断指后不良心理状态对断指再植成活率的影响[J]. 中国心理卫生杂志, 2005, 19(2) :100-101.
5. 吕青, 王爱兰, 丁自海, 等. 现代创伤显微外科护理学[M]. 北京:人民军医出版社, 2001:173.
6. 潘生德, 顾玉东, 侍德. 中华医学会手外科学会上肢部分功能评定试用标准[J]. 中华手外科杂志, 2000, 16(3) :130.
7. 宋艳丽, 郭俐宏, 陈德森. 护理干预对断指再植存活及功能恢复的相关性研究[J]. 护士进修杂志, 2013, 28(16) :1492-1494.
8. 倪娇, 王占忠, 姜涌. 干预对降低断指再植术后血管危象发生的作用[J]. 河北医学, 2013, 19(12) :1904-1906.
9. 刘宁富, 杨绍安, 李松建, 等. 断指再植的临床经验与体会[J]. 中华显微外科杂志, 2003, 26(2) :138-139.
10. 彭婷. 综合心理护理对断指再植病人心理状态和再植指功能康复的影响[J]. 全科护理, 2010, 8(19) :1732-1733.
11. 王海平. 彩色多普勒高频超声对腘窝滑膜囊肿的诊断价值[J]. 华西医学, 2014, 29(4) :734-735.
12. 李信友, 曾勇明, 陆云峰, 等. 平板探测器DSA冠状动脉造影的临床应用及评价[J]. 实用医学影像杂志, 2005, 6(6) :304-306.
13. 张定宝, 肖介川, 高坤华, 等. 断指再植术后彩色多普勒血流与再植指血液循环状况相关性研究[J]. 中国现代医生, 2013, 51(9) :102-103, 105.
14. 徐力扬, 李京雨, 张强, 等. 旋转DSA及三维重建技术在脑血管造影中的应用[J]. 中国医学影像技术, 2003, 19(10) :1377-1379.
15. 顾玉东, 王澍寰. 手外科学[M]. 上海:复旦大学出版社, 2003:603.
16. 陈宏, 章伟文, 李学渊. 断指再植术后动脉危象的处理[J]. 中华手外科杂志, 1999, 15(4) :238.
17. 许培红, 彭文勇, 蔡秋瑾. 连续臂丛阻滞镇痛对断指再植成活率的影响[J]. 全科医学临床与教育, 2010, 8(4) :397-399.
18. 黄河, 李国栋, 肖炳祥, 等. 基于平板DSA数据的神经导航辅助下脑动静脉畸形合并静脉瘤手术1例[J]. 中国临床神经外科杂志, 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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