断肢再植术后感染患者甲襞微循环及血流指标的变化观察

Observation on changes of nailfold microcirculation and hemorheological indexes of severed limb replantation patients with postoperative infections

目的分析断肢再植术后感染患者甲襞微循环及血流变指标的变化,为断肢再植术后感染患者的诊治及预防控制提供依据。方法选取2012年1月-2015年9月收治的56例断肢再植术后感染患者为观察组,同时间段56例断肢再植术后未发生感染患者为对照组,将两组患者的甲襞微循环及血流变指标进行检测与比较,并比较观察组中浅层感染及深部感染者的检测结果。结果观察组甲襞微循环加权积分中的襻周积分、流态积分、管襻积分及总积分分别为(1.64±0.21)、(2.31±0.27)、(1.25±0.14)及(3.32±0.32),其均高于对照组(0.88±0.12)、(1.18±0.15)、(0.64±0.06)及(2.30±0.24),其他甲襞微循环指标及血流变指标也均高于对照组,且观察组中深部感染患者的检测结果高于浅层感染的患者,各个比较指标间差异均有统计学意义(P<0.05)。结论断肢再植术后感染患者甲襞微循环及血流变指标均较高,且浅部感染与深部感染患者的检测结果也存在明显差异,因此应重视对此类患者进行微循环状态的改善。

OBJECTIVE To investigate the changes of nailfold microcirculation and hemorheological indexes of severed limb replantation patients with postoperative infections so as to provide guidance for clinical diagnosis,treatment,and prevention of the postoperative infections in the severed limb replantation patients.METHODS Totally56 patients who underwent the replantation of severed limb and had postoperative infections from Jan 2012 to Sep2015were recruited as the observation group,meanwhile,56 patients who underwent the replantation of severed limb but did not have postoperative infections were set as the control group,then the nailfold microcirculation and hemorheological indexes were detected and compared between the two groups of patients,and the test results were observed and compared between the patients with superficial infections and the patients with deep infections in the observation group.RESULTS As for the nailfold microcirculation weighted integrals,the dirca loop integral of the observation group was（1.64±0.21）,higher than（0.88±0.12）of the control group;the flow integral of the observation group was（2.31±0.27）,higher than（1.18±0.15）of the control group;the loop integral of the observation group was（1.25±0.14）,higher than（0.64±0.06）of the control group;the total integral of the observation group was（3.32±0.32）,higher than（2.30±0.24）of the control group;other nailfold microcirculation indexes and hemorheological indexes were also higher in the observation group than in the control group;in the observation group,the test indexes of the patients with deep infections were higher than those of the patients with superficial infections,and there was significant difference（P〈0.05）.CONCLUSION The nailfold microcirculation and hemorheological indexes are relatively high in the severed limb replantation patients with postoperative infections,and there is significant difference in the test results between the patients with superficial infections and the patients with deep infections,therefore,it is necessary to focus on the improvement of microcirculation state of the patients.