李献凤 班荣曼

【摘要】 目的：探討盐酸罂粟碱注射液微量泵持续给药在小儿断指再植术后的应用效果。方法：选取2016年1月1日-2019年5月30日笔者所在医院收治的36例断指再植术后患儿为本研究对象，根据病案号单双号分为对照组与观察组，各18例。观察组采用盐酸罂粟碱注射液微量泵持续给药，对照组采用肌肉注射盐酸肌注盐酸罂粟碱注射液。对比两组患儿疼痛程度、血管危象发生率和断指存活率、不良反应发生情况及家属满意度评分。结果：观察组术后1、3、7 d疼痛程度显著低于对照组（P<0.05）;观察组血管危象发生率、断指存活率明显优于对照组（P<0.05）;观察组不良反应发生率明显低于对照组（P<0.05）;观察组家属满意度评分明显高于对照组（P<0.05）。结论：在小儿断指再植术后使用微量泵持续泵入盐酸罂粟碱注射液治疗，不仅可以减少血管危象发生率，提高小儿断指再植术后的存活率，加速康复，还具有损伤小、疼痛轻，操作便捷、安全可靠等优势，值得临床进一步推广应用。

【关键词】 盐酸罂粟碱注射液 微量泵持续给药 断指再植术 效果

doi：10.14033/j.cnki.cfmr.2019.28.053 文献标识码 B 文章编号 1674-6805（2019）28-0-03

Application Effect of Papaverine Hydrochloride Injection Micropump Continuous Administration after Replantation of Severed Finger in Children/LI Xianfeng， BAN Rongman. //Chinese and Foreign Medical Research， 2019， 17（28）： -129

[Abstract] Objective： To explore the application effect of continuous administration with Papaverine Hydrochloride Injection by micropump after replantation of severed finger in children. Method： From January 1， 2016 to May 30， 2019， 36 cases of children after replantation of severed finger in our hospital were selected as the study objects. According to the number of cases， they were divided into control group and observation group， with 18 cases in each group.The observation group received continuous administration with Papaverine Hydrochloride Injection by micropump， while the control group received Papaverine Hydrochloride Injection by intramuscular injection.The degree of pain， incidence of vascular crisis， survival rate of finger amputation， occurrence of adverse reactions and family satisfaction scores were compared between the two groups. Result： The pain degrees of the observation group were significantly lower than those of the control group on 1， 3 and 7 d （P<0.05）. The incidence of vascular crisis and survival rate of finger amputation in the observation group were significantly better than those in the control group （P<0.05）. The incidence of adverse reactions in the observation group was significantly lower than that in the control group （P<0.05）. The family satisfaction scores of the observation group were significantly higher than that of the control group （P<0.05）. Conclusion： The treatment of Papaverine Hydrochloride Injection by micropump infusion after replantation of severed finger in children can not only reduce the incidence of vascular crisis， improve the survival rate， accelerate rehabilitation， but also has the advantages of less injury， less pain， convenient operation， safety and reliability， which is worthy of further clinical application.

[Key words] Papaverine hydrochloride Injection Micropump continuous administration Replantation of severed finger Effect

First-authors address： The Fourth Affiliated Hospital of Guangxi Medical University， Liuzhou 545005， China

斷指再植术是显微外科的高难度精细手术，小儿血管细小，手术操作更为精细。血管痉挛是再植术后常见的危险因素之一，罂粟碱具有解除血管平滑肌痉挛的作用，已作为血管再植术后扩血管抗痉挛常用药[1]。罂粟碱传统的给药途径是肌肉注射，此法容易导致注射的部位疼痛、红肿、硬结等。小儿对肌注尤觉恐惧，多次肌注给药易造成小儿哭闹、躁动，诱发再植指体血管危象[2]。罂粟碱微量泵持续给药具有起效快，抗痉挛持续时间长、缓解疼痛、注射损伤少、有利于患儿睡眠，减少不良反应等，效果满意，现将结果报告如下。

1 资料与方法

1.1 一般资料

选取2016年1月1日-2019年5月30日笔者所在医院收治的36例断指再植术后的小儿作为本研究对象，纳入标准：（1）无严重脏器损伤者;（2）无手术禁忌者[3]。排除标准：