手外科医用保温装置的研制及临床应用

DEVELOPMENT AND CLINICAL APPLICATION OF MEDICAL HEAT PRESERVATION DEVICE USED IN HAND SURGERY

目的介绍一种新型医用保温装置,探讨其在断指再植术后的应用价值及疗效。方法设计以水作为加热介质、可设置温度并微电脑控制的医用保温装置。将2010年11月-2014年1月收治的421例行断指再植患者分为两组,其中210例术后9 d内采用医用保温装置保温(试验组),211例术后采用常规烤灯(对照组)。两组患者性别、年龄、致伤原因、伤后至就诊时间、损伤指别及手术持续时间比较,差异均无统计学意义(P>0.05),具有可比性。比较两组术后血管危象发生率、再植指存活率、患者和同室患者自评舒适度,并根据匹兹堡睡眠质量指数量表(PSQI)评价患者睡眠质量。结果术后试验组患者及同室患者舒适度好者分别为188例(89.52%)、201例(95.71%),显著高于对照组的25例(11.85%)、145例(68.72%)。试验组患者睡眠质量按PSQI量表评价,获好105例、中85例、差20例,对照组分别为45、95、71例。术后试验组35例(16.67%)发生血管危象,显著低于对照组的76例(36.02%);试验组196例(93.33%)再植指成活,对照组为181例(85.78%)。以上指标两组间比较差异均有统计学意义(P<0.05)。结论断指再植术后应用医用保温装置对再植手指进行保温,可提高患者舒适度,改善睡眠质量,提高断指再植成功率,减少术后血管危象的发生,并改善对同室患者的影响。

Objective To introduce a new medical heat preservation device, and to explore the application value and effectiveness in replantation of severed fingers. Methods The medical heat preservation device was design, water was used as the heating medium, and temperature was set and controlled by microcomputer. Between November 2010 and January 2014, 421 cases undergoing replantation of severed fingers were divided into 2 groups. Within 9 days after operation, the medical heat preservation device was used in 210 cases（experimental group）, and the conventional heat lamp was used in 211 cases（control group）. There was no significant difference in gender, age, injury cause, the interval between injury and admission, injury finger side, and operation time between 2 groups（P〉0.05）. The vascular crisis rate, success rate of replantation of severed fingers, comfort, sleep quality, and the influence on roommates were compared. Results The comfort and the influence on roommates were good in 188 cases（89.52%） and 201 cases（95.71%） in the experimental group, which were significantly higher than those in the control group（25/211, 11.85%; 145/211, 68.72%）. According to Pittsburgh sleep quality index（PSQI） for sleep quality, the results were good in 105 cases, fair in 85 cases, and poor in 20 cases in the experimental group; the results were good in 45 cases, fair in 95 cases, and poor in 71 cases in the control group. Blood vessel crisis occurred in 35 cases（16.67%） of the experimental group, which was significantly lower than that in the control group（76/211, 36.02%）（P〈0.05）. The survival rate of replantation in the experimental group（196/210, 93.3%） was significantly higher than that in the control group（181/211, 85.78%）（P〈0.05）. Significant differences were found between 2 groups（P〈0.05） in above indexs. Conclusion Medical heat preservation device for replantation of severed fingers can improve the comfortable degree of patients and the quality of sleep, increase the survival rate of finger replantation, and reduce the occurrence of vascular crisis after operation.