Analysis Of Transfusion Volume And Physical Survival Rate Of Patients Who Diagnosed With High Altitude Polycythemia After Replantation Of Severed Finger

Objective: Qinghai Province lies in high altitude, with an average elevation of 3,500 meters above sea where high altitude polycythemia( HAPC)incidence trends to raise. These patients with high blood viscosity got slow blood flow,by blood in a hypercoagulable state may lead to high altitude replantation survival rate is less than the plains, and one of the causes of surgical failure that finger replantation prones to vascular crisis. It was observed through previous replantation failure cases in our hospital and Xining area that high altitude polycythemia patients had a higher morbidity of vascular crisis and replantation failure rate. We give replantation patients conventional treatment, and meanwhile changing the patients transfusion volume, observing correlation between fluid volume in patients with HAPC and finger replantation survival rate, and carrying on the further discussion in this regard.Methods: 43 postoperatives in Xining area with HAPC were randomly divided into two groups, in which Group A has 21 cases, 22 cases to Group B. 3 days after operation, on daily basis A group was given low molecular weight dextran 500 ml, Xueshuantong injection 500 ml, 5% glucose 500 ml + vitamin C injection 2.0g, saline 250 ml + 2.0g cefazolin sodium to prevent infection, saline 250 ml, total rehydration 2000 ml, and Tolazoline 25 mg intramuscular injection given once per day, intramuscular injection of papaverine 30 mg twice a day. Keep indoor temperature within 23-25 degrees. Likewise, 3 days after operation, group B was offered low molecular weight dextran 500 ml, Xueshuantong injection 500 ml, 5% glucose 500 ml + vitamin C injection 2.0g, saline 250 ml + 2.0g cefazolin sodium to prevent infection, saline 2250 ml, total rehydration 4000 ml, and Tolazoline 25 mg intramuscular injection once a day, intramuscular injection of papaverine 30 mg twice per day. Keep indoor 23-25 degrees. Everyday, the postoperative were provided with the same diet and amount of 1000 ml water 3days post operation, as well as in the detection of postoperative blood viscosity, erythrocyte sedimentation rate, erythrocyte sedimentation rate, hemodynamics, and survival statistics surgical complications etc.Result: The postoperative 1d and 3d, two groups of blood rheology have statistically significance the survival rate of Group A is 65.0% of the total, B group survival rate is 85.5%.Conclusion: Patients with high altitude polycythemia treateed with an appropriate increase in transfusion volume, which have a certain effect concerning blood viscosity and blood indexes, the survival rate of replantation surgery has increased. It reflected that the plateau polycythemia patients with high blood viscosity, slow blood flow, blood hypercoagulable state is one of the caused of low survival rate of replantation. The revised treatment that we have adopted postoperative has clinical significance.