摘要
目的 游离皮瓣移植术后分别应用罂粟碱和酚妥拉明预防血管痉挛,探讨微量泵入酚妥拉明在皮瓣移植中的作用.方法 2021年8月-2023年3月巩义市人民医院手足外科收治创面缺损且进行游离皮瓣移植术患者66例,随机分为观察组32例、对照组34例,术后在抗感染、抗凝基础上观察组采用酚妥拉明治疗,对照组采用罂粟碱,连续应用1周;术后均进行常规护理,保暖、患肢制动抬高、禁烟.记录术后即刻、术后第1天、3天、7天皮瓣是否成活、是否发生血管危象、皮瓣血管充盈时间、激光多普勒血流图以及是否发生不良事件.结果 观察组32例、对照组34例皮瓣均成活,血管充盈时间在术后第1天、3天、7天差异均无统计学意义(P＞0.05);两组不良反应发生率在术后第1天差异无统计学意义(P＞0.05),在术后第3天(P＜0.05)、第7天(P＜0.05)差异有统计学意义;两组多普勒血流图比较,组内比较P＜0.05、组间比较P＞0.05,表明随着时间变化两组多普勒血流图比较差异无明显统计学意义.结论 酚妥拉明疗效与罂粟碱疗效相当,但微量泵入酚妥拉明可有效降低不良反应发生率.
Abstract
Objective To compare the effects of two drugs in all directions by comparing the survival rate of the flap,the incidence of vascular crisis,the time of vascular filling,blood oxygen saturation and the incidence of adverse reactions after the application of papaverine and phentolamine respectively after the free flap transplantation.Methods From August 2021 to Mar 2023,66 patients with wound defect and free skin flap transplantation were randomly divided into the test group(32 cases)and the control group(34 cases).On the basis of anti-inflammation and anticoagulation,the test group was treated with phentolamine;The control group was treated with papaverine for 1 week;All patients were given routine nursing care after operation,such as keeping warm,lifting the affected limb and banning smoking.Recorded whether the flap survived,whether there was a vascular crisis,the flap vessel filling time,blood oxygen saturation and whether there were adverse events immediately after the operation,1 day,3 days and 7 days after the operation.Results The 32 flaps in the test group and 34 flaps in the control group survived,and there was no statistical difference in vascular filling time on the 1st,3rd and 7th day after operation(P＞0.05);There was no significant difference in the incidence of adverse reactions between two groups on the first day after operation(P＞0.05),but there was significant difference on the third day after operation(P＜0.05)the seventh day after operation(P＜0.05);The comparison of Doppler blood flow diagrams between the two groups,intra-group comparison(P＜0.05)and inter-group comparison(P＞0.05)showed that there was no significant statistical difference between two groups with time.Conclusion The efficacy of phentolamine is better than that of papaverine.The use of phentolamine can effectively reduce the incidence of adverse reactions.
基金项目
河南省科技攻关计划(2021)(LHGJ20210993)
NETL
NSTL
万方数据