自残性断指再植术后应用枣仁逍遥汤的疗效及预后影响因素

目的 探究自残性断指再植术后应用枣仁逍遥汤的疗效,分析影响术后断指存活的相关因素.方法 选取2017年3月—2020年3月期间在河北省沧州市中西医结合医院手显微外科就诊的行自残性断指再植术的住院患者118例.按照随机数字表法分为治疗组59例,对照组59例.对照组予以断肢再植术后常规治疗.治疗组在对照组基础上,予以枣仁逍...

Efficacy and prognostic factors of Zaoren Xiaoyao Decoction After Replantation of Self-Mutilation Severed Finger

Objective To explore the effect of Zaoren Xiaoyao Decoction on self-mutilation severed finger replantation,and analyze the factors influencing the survival of severed fingers.Methods From March 2017 to March 2020,118 inpatients who underwent self-injury amputated finger replantation were selected in the hand microsurgery of Cangzhou Integrated Traditional Chinese and Western Medicine Hospital,Hebei Province.According to the random number table,they were divided into 59 cases in the treatment group and 59 cases in the control group.The control group received routine treatment after replantation of severed limbs.The treatment group was given Zaoren Xiaoyao Decoction on the basis of the control group.Before and after treatment,observe the patient’s pain,anxiety and depression.After 7 days of treatment,the incidence of vascular crisis and the survival rate of amputated fingers were observed,and the curative effect of Zaoren Xiaoyao Decoction after replantation of self-harm amputated fingers was analyzed.Single factor analysis and multivariate logistic regression analysis were used to analyze the related factors affecting the survival of severed finger after self-harmful finger replantation.Results The VAS scores of the two groups of patients were lower than before treatment for 3 and 7 days(P<0.05),and the VAS scores after 7 days of treatment were lower than 3 days after treatment(P<0.05),and the treatment group was treated for 3 days,After 7 days,the VAS scores were lower than those of the control group,and the differences were statistically significant(P<0.05).After 7 days of treatment,the SDS and SAS scores of the two groups of patients were lower than before treatment(P<0.05),and the SDS and SAS scores of the treatment group were lower than those of the control group,the difference was statistically significant(P<0.05).The scores of TCM syndromes of the two groups of patients were lower than those before treatment for 3 and 7 days(P<0.05),and the scores of TCM syndromes after 7 days of treatment were lower than those of 3 days after treatment(P<0.05),and the treatment group was treated The scores of TCM syndromes after 3 and 7 days were lower than those of the control group,the difference was statistically significant(P<0.05).After treatment,the incidence of vascular crisis in the treatment group was 5.08%(3/59)lower than 15.25%(9/59)in the control group,and the effective rate in the treatment group was 96.61%(57/59)higher than 89.83%(53/59)in the control group),the difference between the two groups was statistically significant(P<0.05).Survival of severed finger was related to the patient’s age,smoking history,diabetes mellitus,severed finger,level of severed finger,warm ischemia time,VAS score,SDS score and SAS score,and the differences were statistically significant(P<0.05).The survival of the severed finger was not related to the patient’s gender,drinking history,hypertension,hyperlipidemia,intraoperative blood transfusion,operation time,and postoperative infection(P>0.05).The smoking history,diabetes,severed finger,severed finger level,warm ischemia time,SDS score and SAS score were all independent risk factors affecting the survival of severed finger,and the differences were statistically significant(P<0.05).Conclusion The use of Zaoren Xiaoyao Decoction after replantation of self-harming severed fingers can reduce pain,stabilize mood,reduce the probability of vascular crisis,and improve the survival rate of severed fingers.The history of smoking,diabetes mellitus,severed finger,severed finger level,warm ischemic time and negative emotions before treatment can affect the survival of severed finger.After an isolated finger injury occurs,the severed finger should be stored reasonably and seek medical treatment in time.After replantation of severed fingers,patients should be persuaded to ban smoking and psychological counseling.Diabetes patients should effectively control blood sugar after surgery.