术中温度干预对断指再植术后功能恢复、炎症因子及并发症的影响

Effects of Intraoperative Temperature Intervention on Functional Recovery,Inflammatory Factors and Complications after Finger Replantation

目的:探究术中温度干预对断指再植术后功能恢复、炎症因子及并发症的影响。方法:选取2021年9月-2023年8月笔者科室收治的72例断指预再植患者为研究对象,按双盲、随机数字表法分为对照组和观察组,各36例。对照组予以常规手术治疗及相关处理;观察组在对照组基础上予以术中温度干预。统计比较两组术中断指区域温度达标率、血液相关指标、再植指功能恢复情况、患者舒适度及并发症发生情况。结果:观察组术中断指区域温度达标率高于对照组(P<0.05)。术后3 h,观察组血液丙二醛(MDA)高于对照组(P<0.05),但术后24、48 h,观察组血液MDA低于对照组(P<0.05);术后3、24、48 h,观察组血液超氧化物歧化酶(SOD)均高于对照组(P<0.05)。术后3 h,观察组舒适度评分高于对照组。术后第5天,观察组IL-1、TNF-α水平低于对照组,IL-10水平高于对照组,差异均有统计学意义(P<0.05)。术后,观察组并发症发生率低于对照组(P<0.05),住院时间短于对照组(P<0.05),患者对手术效果的满意度评分高于对照组(P<0.05)。术后2个月,观察组患者再植手指功能恢复优良率高于对照组(P<0.05)。结论:术中温度干预可降低术后患者血液中炎症因子水平和并发症发生率,并能有效促进术后断指再植的功能恢复,值得在临床推广应用。

Objective To explore the effects of intraoperative temperature intervention on functional recovery,inflammatory factors and complications of severed finger replantation.Methods A total of 72 patients with pre-replantation severed finger treated in the author's department from September 2021 to August 2023 were selected as the research objects,and were divided into control group and observation group with 36 cases in each group according to double-blind and random number table method.The control group was treated with routine operation and related treatment.Observation group was given intraoperative temperature intervention on the basis of control group.The temperature meeting rate of the severed finger area,blood-related indexes,functional recovery of the replantation finger,patient comfort and complications were statistically compared between the two groups.Results The meeting rate of intraoperative temperature of severed finger area in observation group was higher than that in control group(P<0.05).The blood malondialdehyde(MDA)in observation group was higher than that in control group 3 h after operation(P<0.05),but the blood MDA in observation group was lower than that in control group 24 and 48 h after operation(P<0.05).At 3,24 and 48 h after operation,the blood superoxide dismutase(SOD)in observation group was higher than that in control group(P<0.05).At 3 h after operation,the comfort score of observation group was higher than that of control group.On the 5th day after surgery,the levels of IL-1 and TNF-αin observation group were lower than those in control group,and the levels of IL-10 were higher than those in control group,with statistical significance(P<0.05).After the operation,the complication rate of the observation group was lower than that of the control group(P<0.05),the length of hospital stay was shorter than that of the control group(P<0.05),and the satisfaction score of the patients with the operation effect was higher than that of the control group(P<0.05).Two months after operation,the functional recovery rate of replantation finger in observation group was higher than that in control group(P<0.05).Conclusion Intraoperative temperature intervention can reduce the level of inflammatory factors in the blood and the incidence of complications,and can effectively promote the functional recovery of postoperative severed finger regraft,which is worthy of clinical application.