拇指及手指再造手术血管危象164例临床分析  

Etiology and management of vascular compromise in toe-to-hand transfer(an analysis of 164 cases)

作　　者：侯书健[1] 程国良[1] 方光荣[1] 王振军[1] 张元信[1] 张云飞[1] 滕国栋[1] 

机构地区：[1]中国人民解放军第四○一医院手外科,青岛市266071

出　　处：《中华显微外科杂志》2005年第2期130-132,共3页Chinese Journal of Microsurgery

摘　　要：目的探讨拇、手指再造血管危象的诱因、处理方法与预防措施。方法复习164例拇、手指再造血管危象的病历,分别记录血管危象的类型、发生时间、诱发原因、处理方法与转归,并对结果进行统计、分析。结果本组血管危象发生率为18.4%。其中动脉栓塞85例,动脉痉挛52例,静脉栓塞6例,静脉痉挛14例,动静脉均栓塞7例,经处置后,缓解150例188指,坏死14例14指,处置成功率为93.1%(188/202)。结论拇、手指再造血管危象的及时、恰当处置对提高手术成功率至关重要。为了减少血管危象的发生,应采取适当的预防措施。Objective To investigate the inducing factors of intra-and postoperative vascular compromise in toe-to-hand transfer and their prevention and management. Methods The history records of 164 toeto -hand cases complicated with vascular compromise were reviewed. The classification, inductive causes, vascular compromise occurrence time, treatment and outcome were counted and analyzed. Results The overall occurrence rate of vascular compromise of this series of cases was 18.4%. Among them, arterial thrombosis occurred in 85 cases, arterial spasm in 52 cases, venous thrombosis in 6 cases, venous spasm in 14 cases, thrombosis of both artery and vein in 7 cases. After treatment, relief of vascular compromise obtained in 188 digits of 150 patients. Necrosis of reconstructed digits occurred in 14 digits of 14 patients. The overall successful rate was 93.1%. Conclusion It is of cardinal importance to timely and correctly treat the vascular compromise of toe-to-hand transfer whether happened intra-or postoperatively. This is the key to access high successful rate. Preventive measures are even more beneficial than proper management after its occurrence.

关 键 词：血管危象 手指再造手术 临床分析 拇指 预防措施 处理方法 中动脉栓塞 手术成功率 发生时间 诱发原因 动脉痉挛 静脉栓塞 静脉痉挛 发生率 动静脉 

分 类 号：R658[医药卫生—外科学]