Analysis of the cause and prevention of vascular crisis in finger replantation / 中国基层医药

ABSTRACT

To explore the causes of vascular crisis caused by replantation of severed finger ,and summarize the experience of prevention and treatment.Methods From April 2015 to February 2017,108 patients with wounded finger treated in the First People＇s Hospital of Yongkang were divided into two groups according to the occurrence of postoperative vascular crisis situationthe control group (56 cases,vascular risk),the observation group (52 cases,vascular crisis happened ).The clinical data of all patients were collected ,the various data were compared , and the causes of vascular crisis were analyzed.The observation group was given low molecular dextran treatment ,the changes of blood coagulation function indicators before and after treatment were observed .Results The age, disconnection plane,ischemia time had statistically significant differences between the two groups ( all P ＜0.05). After treatment,the four coagulation function index in the observation group [ fiber protease(3.32 ±0.29) g／L, activated partial thrombin time(27.56 ±2.08) s,thrombin time(12.13 ±1.62) s,prothrombin time(11.47 ± 1.29)s] were improved obviously (t＝4.86,8.63,6.04,4.70,all P＜0.05).Conclusion The age,disconnection plane and ischemic time are the factors that cause vascular crisis.In addition,postoperative pain, patients＇mood, postoperative posture and other factors may also lead to vascular crisis.Preoperative assessment of the condition should be done well,postoperative monitoring should be strengthened ,and prophylactic medication can be used to prevent vascular crisis.