前列地尔预防和治疗显微外科术后血管危象的临床对照研究

The effect of Alprostadilon the prevention and treatment of vascular crisis after microsurgery

目的:探讨前列地尔(PGE1)用于显微外科术后血管危象预防治疗中的临床效果。方法:收集自2012年7月至2017年12月在我院治疗的18～50岁显微外科手术患者80例,随机分为两组各40例,其中治疗组给予前列地尔(PGE1)作为防治血管痉挛药物,对照组则给予罂粟碱治疗,其他围手术期基本抗感染及抗凝血治疗方案及护理标准一致。记录各治疗组术后血液循环情况,包括血管危象发生率、与血管危象相关的再手术率、组织瓣坏死率,以及住院期间药物治疗费用。结果:PGE1治疗组患者术后组织瓣坏死率及血管危象相关的再手术率为2.5%、罂粟碱对照组患者术后组织瓣坏死率及血管危象相关的再手术率均为2.5%,比较无统计学意义(P≥0.05);PGE1治疗组患者术后血管危象发生率2.5%、罂粟碱对照组患者术后血管危象发生率为7.5%,比较无统计学意义(P≥0.05);PGE1治疗组与罂粟碱对照组患者住院药物费用相比较,PGE1治疗组患者药物费用明显高于罂粟碱对照组,差异有统计学意义(P<0.05)。结论:前列地尔(PGE1)能够有效地预防和治疗显微外科术后血管危象,可作为治疗显微外科围手术期血管危象的可靠的供选治疗方案,但是治疗费用会明显增加。

Objective:To observe the effects of Alprostadil(PGE1)on the prevention and treatment of vascular crisis after microsurgery.Methods:The cases were the 80 patients who were receive the special microsurgery during the July 2012 to December 2017.Two groups were designed:PGE1 group and papaverine group.All the patients were assigned to these two groups randomly.Incidence of vascular crisis,reoperation rate associated with vascular crisis,rate of tissue flap necrosis and medical expenses during hospitalization were record.Results:Incidence of vascular crisis,reoperation rate associated with vascular crisis,rate of tissue flap necrosis were both 2.5%in PGE1 group,it has no statistically significant between these two group.But the medical expenses was significant higher in PGE1 group.Conclusions:The PGE1 can be effectively prevent and treat vascular crisis after microsurgery,It can be used as a reliable alternative treatment for perioperative vascular crisis in microsurgery,although the cost will be higher.