Observation Of The Effect Of Prostadil Dry Emulsion In The Application Of Hand Artery Injury

Objective: This study focuses on the value of prostadil dry emulsion in the application of hand artery injury.To compare the differences in the efficacy of prostadil and heparin in the treatment of hand artery injury.So as to provide new ideas and clinical evidence for the application of anticoagulant drugs after vascular anastomosis,minimize the adverse reactions after operation,and achieve the best therapeutic goal in the condition of minimal influence on blood coagulation series and hemorrheology series.Methods: A total of 50 cases of hand artery injuries from December 2016 to January 2018 in Affiliated Hospital of Yan'an University were collected and randomly divided into experimental group and control group,25 cases in each group.Patients' gender,age,distance and visiting time were recorded,and the informed consent was signed.Two there was no difference in the operation and basic treatment under the premise of the experimental group were given papaverine + alprostadil dry emulsion treatment,the control group was given papaverine + heparin treatment.Observe two groups of patients after treatment of thrombosis,the number of cases of adverse reaction cases,the coagulation series,prothrombin time(PT),activated partial thromboplastin time(APTT),fibrinogen(FIB),the blood rheology series,high and low shear whole blood viscosity,plasma viscosity and the related indexes,.Seriously collect data,and finally use SPSS20.0 statistical software to select an appropriate analysis method and perform statistical analysis on the collected data.Results: 1.comparison between the experimental group and the control group The experimental group 19 male,6 female,control group: 17 male,8 female,There was no significant difference in the proportion of men and women in the two groups.;The age range of the experimental group was 20-55 years old,average age(41.76±9.18),The age range of the control group was 18-54 years old,average age(39.48±9.23),There was no significant difference in age composition between the experimental group and the control group;The visiting time after injury in experimental group,1-7 hours,an average of 4.30±2.29 hours.,The visiting time after injury in control group,1.5-7 hours,an average of 4.24±2.24,treatment time after injury there is no significant difference;Divided into small blood vessel group and microvascular group according to blood vessel diameter,1.5mm-10 mm was small vessels,<1.5mm was microvessels,in the experimental group,small blood vessels / microvessels was 15/10,in the control group: small blood vessels / microvessels was 17/8.which had no significant difference between the experimental group and the control group in the size of the diameter;In the experimental group,bilateral vascular injury(replantation of severed finger)was 4 cases and 21 cases of unilateral vascular injury,bilateral vascular injury/unilateral vascular injury 4/21;In the control group,bilateral vascular injury(replantation of severed finger)was 5 cases and 20 cases of unilateral vascular injury,bilateral vascular injury/unilateral vascular injury 4/21.There was no statistically significant difference between two groups in whether the injured vessels were unilateral or bilateral.Therefore,the general data of two groups met the requirements of statistics,and could be compared.2.Comparison of the number of thrombus formation and the number of adverse reactions in the experimental group and the control groupObserved whether adverse reactions occurred during the postoperative drug use in the 2 groups of patients,and perform ultrasound examination after wound healing to check whether the blood vessels are smooth.The incidence of adverse reactions was 2 in the experimental group,8% in the experimental group,and 8 in the control group,the incidence rate was 32%.Two groups of postoperative adverse reaction rate were significant difference(x 2=4.500,P<0.05);The number of cases of thrombosis: 1 cases in the experimental group,the treatment success rate of 96%;2 cases of the control group,with a successful rate of 92%.The three cases of thrombosis were unilateral vascular injuries.The number of cases of thrombosis after surgery was compared between the two groups.Two groups of postoperative thrombosis were no significant difference(x 2=2.083,P>0.05).3.Comparison of the changes of blood coagulation series related indexes before and after treatment in the experimental group and the control groupChanges in hemagglutination index(A1: first days postoperatively / preoperative,A2: fourth days postoperatively / preoperative,A3: seventh days postoperatively / preoperative.)Comparison of prothrombin time:The value of the experimental group: A1(1.00±0.29)A2(1.02±0.34)A3(1.21±0.14)The value of the control group: A1(1.03±0.47)A2(1.09±0.53)A3(1.17±0.51)There was no statistically significant difference in A1,A2 and A3 between two groups(t=0.253,P>0.05),(t=0.567,P>0.05),(t=0.413,P>0.05).Comparison of activated partial thromboplastin time:The value of the experimental group: A1(0.96±0.97)A2(1.42±0.81)A3(1.66±0.77);The value of the control group: A1(0.86±0.62)A2(1.27±0.73)A3(1.65±0.60),There was no statistically significant difference.(t=0.433,P>0.05),(t=0.694,P>0.05),(t=0.061,P>0.05).comparison of fibrinogen values:The value of the experimental group: A1(0.49±0.39)A2(0.64±0.48)A3(1.04±0.57);The value of the control group: A1(0.58±0.42)A2(0.80±0.53)A3(0.94±0.52).There was no statistical difference between the two groups of FIB,A1,A2 and A3,(t=0.762,P>0.05),(t=1.056,P>0.05),(t=0.645,P>0.05)4.Comparison of changes of blood rheology related indexes before and after treatment in the experimental group and the control groupChanges in blood rheology index(A1: first days postoperatively / preoperative,A2: fourth days postoperatively / preoperative,A3: seventh days postoperatively / preoperative.The relatively high shear whole blood viscosity:The value of the experimental group was A1(0.57±0.59)A2(0.83±0.69)A3(0.93±0.73)The value of the control group was A1(0.70±0.38)A2(0.78±0.41)A3(0.85±0.44).Comparison of two groups of whole blood high shear viscosity of A1,A2,A3 were no statistically significant difference,respectively(t=0.890,P>0.05),(t=0.325,P>0.05),(t=0.459,P>0.05)Comparison of low blood viscosity of whole blood:The value experimental group: A1(0.47±0.66)A2(1.10±0.77)A3(1.36±1.04): control group A1(0.76±0.60)A2(1.38±0.76)A3(1.84±1.00),two groups of low shear viscosity of A1,A2,A3 were no statistically significant the difference,respectively(t=1.656,P>0.05),(t=1.287,P>0.05),(t=1.660,P>0.05)See table 2-4-2.Comparison of plasma viscosity:The value of the experimental group: A1(0.13±0.28)A2(0.33±0.24)A3(0.54±0.27),the value of the control group was A1(0.26±0.23)A2(0.49±0.26)A3(0.60±0.30)There was no statistically significant difference in A1,A2 and A3 between the two groups in thromboplastin time,respectively(t=1.647,P>0.05),(t=2.207,P>0.05),(t=0.627,P>0.05).Conclusion: 1.Prostadil dry emulsion is used for the treatment of hand artery injury after operation.Compared with heparin sodium,the success rate is similar and the adverse reaction is small.2.Prostadil and heparin sodium have the same effect on the increase of blood coagulation index after the operation of hand artery injury,the difference is not statistically significant.3.The effect of prostadil and heparin sodium on the hemorheological indexes after the operation of hand artery injury was not statistically significant.4.The use of prostadil dry emulsion does not need to monitor blood coagulation,and the effect of anticoagulation is accurate and safe.It can be used for the treatment of hand vascular anastomosis.