术后镇痛对断指再植成活的影响

Effect of postoperative analgesia on survival of finger replantation

目的探讨断指再植术后镇痛效果对于患者断指再植成功率的影响.方法按照患者意愿分为术后患者自控静脉镇痛组和常规对照组.比较两组在镇痛效果、血管危象发生情况、断指再植成活率以及患者血管内皮生长因子（VEGF）表达情况.结果术后患者自控静脉镇痛组术后0～12h、12～24h以及24～72h疼痛视觉模拟评分分别为（4.3±2.3）、（3.6±1.9）、（2.4±1.7）分,镇痛效果优于常规对照组（P〈0.05）.患者自控静脉镇痛组血管危象发生率低于常规对照组（P〈0.05）.患者自控静脉镇痛组在术后18～24h、66～72h、114～120hVEGF分别为（56.43±19.64）、（98.40±25.46）、（68.67±18.94）pg/mL,各时间点均高于常规对照组.患者自控静脉镇痛组断指再植成活率94%高于常规对照组76%,差异有统计学意义.结论断指再植术后镇痛效果影响断指再植成功率.

Objective To discuss the influence of analgesic effect after the finger replantation on the finger replantation effect of pa-tients. Methods The patients were divided into the self-control analgesic group after the operation and the conventional control group ac-cording to wills of patients, and the two groups mwere compared in terms of analgesic effect, occurrence of blood vessel crisis, survival rate of finger replantation and VEGF manifestation of patients. Results The self-control analgesic group after the operation was superior to the conventional control group in terms of analgesic effect. The occurrence of blood vessel crisis of the self-control analgesic group was lower than that of the control group. However, the VEGF manifestation of the self-control analgesic group was higher than that of the control group. The self-control analgesic group was better than the control group in terms of the survival rate of finger replantation. Conclusion The analge-sic effect after the finger replantation has an effect on the success rate of finger replantation.