围手术期应用川芎嗪干预游离皮瓣移植的临床研究

目的探讨川芎嗪对皮瓣移植前后血流变及凝血功能等方面的影响,从而为活血化瘀中药在显微外科领域的应用提供新的线索。方法60例需行游离皮瓣移植的患者,随机分成川芎嗪治疗组(治疗组)和低分子右旋糖酐对照组(对照组),两组疗程均为7天。观察皮瓣成活的情况等,并作血液流变学及凝血4项(凝血酶原时间、凝血酶时间、活化部分凝血活酶时间及纤维蛋白原)检查。结果两组患者临床疗效和血液流变学指标比较差异无统计学意义(P0.05),但治疗组对凝血功能4个指标术后24、48、72 h的影响较对照组小(P0.05)。结论传统中药川芎嗪对显微外科游离皮瓣移植的血管危象具有较好疗效,有很好的临床应用价值。

Perioperative Intervention of Tetramethylpyrazine on Free Skin Flap Transplantation

Objective To study the impacts of tetramethylpyrazine （TMP） intervention on hemorrheology and blood coagulation before and after free skin flap transplantation, in order to provide new clues of applying Chinese drugs for activating blood circulation and removing stasis in microsurgery. Methods Sixty patients undergoing free skin flap transplantation were randomly and equally assignd to two groups, the treatment group administered with tetramethypyrazine, the control group with low molecular dextran, both were treated for 7 days. The survival rate of transplanted flap, hemorrheologic parameters and four blood coagulation associated indices （prothrombin time, thrombin time, activated prothrombin time and fibrinogen） were detected before and after treatment. Results Comparisons of clinical efficacy and hemorrheologic indices showed no significant difference between the two groups （ P 〉0.05）, but TMP showed less impacts on the four blood coagulation associated indices at the 24, 48 and 72 h after operation （ P 〈 0.05）. Conclusion TMP could prevent blood vessel crisis after free skin flap transplantation, so it is valuable in microsurgical clinical application.