川芎嗪在游离皮瓣移植术后的应用体会

Study on the Application of Tetramethylpyrazine After the Transferring of Flap with Vascular Anastomosis

目的 :探讨川芎嗪在显微外科游离皮瓣移植术后防治血管危象的作用 ,为游离皮瓣移植术后的抗凝治疗用药提供新的线索。方法 :5 9例游离皮瓣移例植术后病人 ,随机分成川芎嗪治疗组和肝素治疗组 ,川芎嗪治疗组用川芎嗪注射液静滴作为术后抗凝用药 ,肝素治疗组用肝素静脉滴注作抗凝用药。从血管危象发生的有无、再植皮瓣血运情况、伤口愈合情况等几方面来综合判断 2组的治疗效果 ,并作凝血四项检查了解 2组病人用药后凝血功能的变化。结果 :2组病人在临床疗效上无显著性差异 (P>0 .0 5 ) ,但川芎嗪对病人凝血功能的影响上较肝素小 (P<0 .0 5 )。结论 :川芎嗪用于游离皮瓣移植术后预防血管危象具有较好疗效 ,有临床应用价值。

Objective:To study the effect of Tetramethylpyrazine (TMP) on preventing blood vessel crisis after transferring operation of flap with vascular anastomosis, and provide some new medical ideas and methods for this kind of operations.Methods:After had received transferring operation of flap with vascular anastomosis, 59 cases were randomly divided into 2 groups: one group of cases took TMP injection to avoid blood vessel crisis, and cases of the other group took heparin injection. By observing three factors: (1) whether or not there was a blood vessel crisis, (2) the condition of circulation of transferred flap and (3) the state of wound healing, the effect of TMP and heparin on transferring of flap with vascular anastomosis was determined. Moreover by observing 4 indexes of blood coagulation the effect of both the TMP and heparin could have on coagulation was measured.Results:both groups of cases had resemble result(P>0.05), and TMP had less influence on blood coagulation than heparin(P<0.05).Conclusion: TMP could prevent blood vessel crisis after transferring of flap with vascular anastomosis and had the valuation for clinical application in microsurgery.