断指再植术后大黄敷脐对再植成活率及血清内皮素的影响

Effect of Dahuang Umbilical Applying on Survival Rate of Replantation and Serum Endotoxin after Replantation of Severed Finger

目的:观察断指再植术后大黄敷脐对再植成活率及血清内皮素(ET)的影响。方法:将断指再植手术患者40例随机分为对照组(20例,24指)及治疗组(20例,26指)。对照组采取常规处理;治疗组在常规处理方案的基础上术后4 h用大黄敷脐。比较2组排便情况、疼痛视觉模拟评分量表(VAS)评分及断指再植术后再植成活率。检测2组血清ET水平。结果:治疗组成活率92.31%,明显高于对照组62.50%,差异有统计学意义(P<0.01)。治疗组术后48 h及术后96 h排便次数、矢气次数多于对照组,VAS评分少于对照组,差异均有统计学意义(P<0.01)。术后96 h及术后1周,治疗组血清中ET水平少于对照组同期,差异均有统计学意义(P<0.01)。结论:断指再植术后大黄敷脐可较好防止便秘,减缓疼痛,提高再植成活率,其能降低血清ET水平可能与其疗效有关。

Objective： To observe the effect of Dahuang umbilical applying on survival rate of replantation and serum endotoxin（ET） after replantation of severed finger.Methods：Divided 40 cases of patients who had received the replantation of severed finger into control group with 20 cases（24 replanted fingers） and treatment group with 20 cases（26 replanted fingers）randomly.The control group was given routine treatment,while the treatment group was additionally received Dahuang umbilical applying after 4 hours of replantation.Compared the defecation,visual analog scale（VAS）,and survival rate of severed finger after replantation in both groups.Detected the serum ET level in two groups.Results：The survival rate was92.31% in the treatment group,being evidently higher than 62.50% in the control group,the difference being significant（P〈0.01）.At the 48 th and 96 th hour after replantation,times of defecation and flatus in the treatment group were obviously more than those in the control group,and VAS score in the treatment group was obviously lower than that in the control group,the difference being significant（P〈0.01）.At the 96 th hour and one week after replantation,serum ET level in the treatment group was obviously lower than that in the control group in the same period,the difference being significant（P〈0.01）.Conclusion： The application of Dahuang umbilical applying after replantation of severed finger can effectively prevent constipation,reduce pain,and improve the survival rate of replantation,and its fuction of declining the serum ET level may be related to its curative effect.