罂粟碱给药途径对肢体损伤血管修复术后皮肤温度的影响及保护作用

目的探讨罂粟碱给药途径对肢体损伤血管修复术后皮肤温度的影响及保护作用。方法选择2008年10月～2010年7月佛山市中医院骨二科的住院患者105例，采用随机数字法将其分为A组（25例）、B组（26例）、C组（27例）和对照组（27例）。A组在术后即刻口服罂粟碱，B组在术后即刻肌注罂粟碱，C组在术后即刻静脉输入罂粟碱，对照组则常规治疗，不运用任何血管扩张药物。观察四组患者皮瓣成活面积、成活率、血管危象发生率及皮温差，及不同用药途径的皮温升高时间和持续时间。探讨肢体损伤血管修复术后皮肤温度的影响与给药途径的关系进行。结果A、B、C组皮瓣成活面积显著高于对照组，差异有统计学意义（P〈0．05）。不同用药途径比较，皮肤温度升高方面，A组给药速度最快，C组最慢；但持续时间则三者之间相反，且差异有高度统计学意义（P〈0．01）。A、B、C三组皮温差显著低于对照组，差异有统计学意义（P〈0．05）。A、B、C三组指（趾）体和皮瓣成活率（92．0％、100．O％、85．2％）高于对照组（85．2％），血管危象发生率（8．0％、3．9％、0．0％）低于对照组（7．4％），差异均有统计学意义（P〈0．05）。A、B、C三组组内比较，差异无统计学意义（P〉0．05）。结论罂粟碱虽然给药途径不同，肢体损伤血管修复术后患侧的皮肤温度均可得到提高，其中以静脉给药途径最佳，肌内注射次之。

Influence and protective effect of skin temperature after repairing vascular injury in limbs by papaverine administration

Objective To explore the influence and protective effect of skin temperature after repairing vascular injury in limbs by papaverine administration. Methods 105 hospitalized patients from October 2008 to July 2010 in the Second Department of Orthopedics in Foshan Hospital of Traditional Chinese Medicine were collected,and they were divided into 25 cases of group A, 26 cases of group B, 27 cases of group C and 27 cases of control group according to the method of random number. The patients in group A were taken papaverine orally in immediately after the surgery, group B were injected papaverine muscularly, group C were infused papaverine through vein, while the control group were given conventional treatment and did not use any vasodilator drugs. The effects of skin temperature after repairing vascular injury in limbs and it＇s relation with the ways of administration were explored. Results The flap survival area of group A, B, C were significantly higher than that of the control group, the differences were statistically significant （P 〈 0.05）. The comparison of different ways of administration showed that the skin temperature of group A raise fastest, and group C raise slowest; but the duration was the opposite, the differences were statistically significant （P 〈 0.01）. The difference in skin temperature of group A, B, C were significantly lower than that of the control group, the difference was statistically significant （P 〈 0.05）. The difference among the three groups was statistically significant （P 〈 0.05）. The finger （toe） and flap survival rate of group A, B, C （92.0%, 100.0%, 85.2%） were higher than that of the control group （85.2%）, and the incidence of vascular crisis （8.0%, 3.9%, 0.0%） were lower than that of the control group （7.4%）, the differences were significant difference （P 〈 0.05）. There was no significant difference among group A, B, C （P〉 0.05）. Conclusion Different papaverine administration ways can improve the limbs ipsilateral skin tem