International Medicine and Health Guidance News ›› 2022, Vol. 28 ›› Issue (15): 2073-2078.DOI: 10.3760/cma.j.issn.1007-1245.2022.15.001

• Literature Analysis •     Next Articles

Meta-analysis of risk factors of postoperative vascular crisis in patients after severed finger replantation

Liu Fengjing1,2, Liu Huiwen1, Wang Meiling1, Chen Bizhen3   

  1. 1 Nursing School, Fujian University of Traditional Chinese Medicine, Fuzhou 350100, China;  2 Department of Hand Surgery, Fuzhou Second Hospital, Fuzhou 350000, China; 3 Nosocomial Infection Management Office, Second People's Hospital, Fujian University of Traditional Chinese Medicine, Fuzhou 350003, China
  • Received:2022-05-17 Online:2022-08-01 Published:2022-08-01
  • Contact: Chen Bizhen, Email: 573073198@qq.com
  • Supported by:
    Fujian Department of Science and Technology, Fujian Center of First Aid for Trauma Orthopedics and Clinical Medicine Research of Rehabilitation (2020Y2014)

断指再植患者术后血管危象危险因素的meta分析

刘凤璟1,2  刘辉文1  王美玲1  陈碧贞3   

  1. 1福建中医药大学护理学院,福州 350100; 2福州市第二医院手外科,福州 350000; 3福建中医药大学附属第二人民医院医院感染管理处,福州 350003
  • 通讯作者: 陈碧贞,Email:573073198@qq.com
  • 基金资助:
    福建省科学技术厅、福建省创伤骨科急救与康复临床医学研究中心(2020Y2014)

Abstract: Objective To systematically evaluate the risk factors of vascular crisis after replantation of severed fingers. Methods The databases Wanfang, CNKI, VIP, China Biomedicine, Web of Science, PubMed, and The Cochrane Library were searched from their establishment to April 30, 2022. According to the inclusion and exclusion criteria, two researchers independently screened the literatures, extracted the data, and evaluated the literatures. The Revman 5.3 software was used for the meta-analysis of risk factors. The results were expressed by odds ratio (OR) and 95% confidence interval (CI). When P≥0.1 and I2<50%, the fixed effect model was used for the meta analysis. When P<0.1 and/or I2≥50%, the random effect model was used for the meta analysis. Results A total of 9 literatures were included, including 1 728 patients, and 303 patients had vascular crisis, and the incidence of vascular crisis was 21.26%. Meta analysis showed that gender (women) (OR=3.73, 95%CI 2.04-6.82, P<0.000 01), age < 12 years (OR=4.71, 95%CI 3.41-6.50, P<0.000 01), smoking history (OR=4.06, 95%CI 3.08-5.35, P<0.000 01), ischemic time > 10 hours (OR=3.04, 95%CI 1.52-6.07, P=0.002), cause of injury (crush avulsion injury) (OR=4.09, 95%CI 2.89-5.78, P<0.00001), and dissociation plane (distal segment dissociation) (OR=4.10, 95%CI 3.03-5.54, P<0.000 01) were the risk factors of vascular crisis after finger replantation. Conclusions The incidence of vascular crisis after replantation of severed fingers is high. Targeted preventive measures should be taken for replantation patients such as female, young age, smoking history, long ischemic time, crush avulsion injury, and distal segment disconnection, so as to reduce the incidence of vascular crisis and improve the severed fingers' survival rate after replantation.

Key words: Replantation of severed fingers, Vascular crisis, Risk factors, Meta-analysis

摘要: 目的 系统评价断指再植术后血管危象的危险因素。方法 检索数据库万方、知网、维普、中国生物医学、Web of Science、PubMed、The Cochrane Library,检索时限为建库至2022年4月30日。由2名研究人员按照纳入和排除标准,独立进行文献筛选、资料提取、文献评价,运用Revman 5.3软件进行危险因素的meta分析,统计结果用比值比(OR)及95%置信区间(CI)表示,异质性检验当P≥0.1且I2<50%时采用固定效应模型,P<0.1和/或I2≥50%,采用随机效应模型进行meta分析。结果 最终纳入9篇文献,共1 728例患者,发生血管危象303例,血管危象发生率为21.26%。meta分析显示,性别(女性)(OR=3.73,95%CI 2.04~6.82,P<0.000 01)、年龄<12岁(OR=4.71,95%CI 3.41~6.50,P<0.000 01)、吸烟史(OR=4.06,95%CI 3.08~5.35,P<0.000 01)、缺血时间>10 h(OR=3.04,95%CI 1.52~6.07,P=0.002)、伤因(挤压撕脱伤)(OR=4.09,95%CI 2.89~5.78,P<0.000 01)、离断平面(末节离断)(OR=4.1095%CI 3.03~5.54,P<0.000 01)是断指再植术后血管危象的危险因素。结论 断指再植术后血管危象发生率较高,应针对女性、低龄、有吸烟史、缺血时间长、挤压撕脱伤、末节离断等再植患者采取有针对性的预防措施,以减少血管危象的发生,提高断指再植的成活率。

关键词: 断指再植术, 血管危象, 危险因素, meta分析