去表皮包埋甲根部以远离断再植的临床研究  

Analysis on a Replantation Method for Beyond Fingernail Root Amputation with Embedding to Subcutaneous Pocket

作　　者：曹太阳[1] 陈世玖[1] 吕占武[1] 龙航[1] 高峰[1] 

机构地区：[1]遵义医学院第五附属珠海医院,广东珠海519100

出　　处：《中国医学创新》2013年第12期6-8,共3页Medical Innovation of China

摘　　要：目的：探讨去表皮包埋甲根部以远的离断再植方法。方法：本院2011年-2012年甲根部以远完全离断指20指，彻底清创后，显微镜下探查血管，失去吻合再植，行骨折内固定、神经吻合、离断指原位缝合，去表皮后将指包埋于鱼际或者腹部处，常规防感染等治疗，3周后局部浸润麻醉下取出，局部保持湿润、促进上皮化。结果：16指存活，外形良好，随访6～12个月，手指屈伸正常，外形良好，其中2指指体细小、惧冷，两点辨别觉2-7mm。其余4指取出后有2指完全坏死，2指指端坏死，给予残端修整治疗。结论：甲根部以远的离断，去表皮包埋治疗，在失去血管吻合条件下是一种理想的治疗方案。Objective： To discuss a replantation method for beyond fingernail root amputation with embedding to subcutaneous pocket. Methods： From 2011 to 2012, the embedding method was applied to 20 beyond fingernail root amputations in 20 patients. After debideroent of amputated finger, we had not found anastomosis vessel of amputated fingers through microscope. Fractured bone segrnent fixed with one kirschner wire, connected the nervus, stutured the amputated fingers to normal position and de-epithelialized amputated part to skin dermis, the reattached parts were inserted into the subcutaneous pocket of ipsilateral palm or abdominal. After three weeks, the reattached fingers were removed from the subcutaneous pocket. Result： Sixteen fingers had recovered completely. Six months to one year later, the replanted 14 fingers had satisfactory sensation （ discrimination 2-7 tom ）, appearance and perfect function. 2 fingers were lessen and sensation of chill. There were necrosis happened in another 2 fingers, and the other 2 fingertips.Conclusion： The roethod of embodding to subcutaneous pocket is a effective treatment for beyond fingernail root amputation, which loses vascular anastomo-sis conditions.

关 键 词：甲根以远离断指 去表皮包埋 再植 

分 类 号：R658.1[医药卫生—外科学]