仅吻合动脉的指尖再植30例  

Replantation of only anastomosing artery of fingertip-- report of 30 cases

作　　者：张乃臣[1] 顾加祥[1] 刘宏君[1] 潘俊博[1] 田恒[1] 

机构地区：[1]江苏省苏北人民医院,江苏扬州225001

出　　处：《实用手外科杂志》2012年第4期352-354,共3页Journal of Practical Hand Surgery

摘　　要：目的探讨指尖再植的治疗经验．方法对30指指尖离断进行再植，吻合指端动脉弓以远一条动脉分支21指．吻合两条动脉弓分支6指，指端动脉弓以近吻合一条指动脉3指，均未吻合静脉。缝合神经28指．术后所有再植指均未给予指腹侧方切口放血或甲床放血治疗。结果成活28指，坏死2指．成活率为93．3％。术后随访6～36个月，7指指甲有不同程度畸形，5指指腹轻度萎缩，3指指腹软组织略变硬．1指创口有瘢痕痛。其中16指外形良好，感觉恢复正常，两点辨别觉为3-6mm，运动功能正常、结论对离断指内血管损伤程度的正确评估和高质量的血管吻合是指尖再植成活的关键，指尖再植静脉不易吻合．术后可根据再植指情况给予放血治疗。Objective To investigate the treatment of fingertip replantation. Methods 30 severed fingertips were replanted. The vascularization procedures were as follow： anastomosis of only one branch of the distal digital arterial arch in 21 digits, anastomosis of two branches of the digital arterial arch in 6 digits, and anastomosis of the proximal branches of the digital artery in 3 digits, all digits were not anastomosed digital veins. To restore the sensation, the digital nerve was directly sutured in 28 digits, and all digits were not treated with the small incision blood-letting after operation. Results 28 replanted fingertips survived,4 fingertips failed, the survival rate was 93.3%. The postoperative follow-up period was 6 to 36 months. Varying degree of deformities of nails were seen in 7 digits, gently atrophy of the finger pulp in 5 digits, slightly hardness of the pulp soft tissue in 3 digits, scar pain in 1 digit. In which satisfactory appearance and function were obtained in 16 digits, with normal sensation and 2-PD was 3-6ram. Conclusion Accuracy assessment of the vascular injury degree of fingertips and high quality anastomosis were crucial to the success of fingertip replantation.Vein anastomosis is not easy, blood-letting therapy sometimes is needed after replantation.

关 键 词：手损伤 指尖再植 治疗 

分 类 号：R658.1[医药卫生—外科学]