吻合浅静脉的邻指逆行指动脉Y-V血管蒂皮瓣的临床应用  

Clinical application of reverse island flap of the adjacent digit pedicled with the Y-V vascular of digital artery by anastomosis of superficial veins

作　　者：刘宇舟 芮永军 糜菁熠 邱扬 华雍 

机构地区：[1]无锡市第九人民医院(手外科医院)手外科,江苏省无锡市214062

出　　处：《中华显微外科杂志》2013年第4期313-316,共4页Chinese Journal of Microsurgery

摘　　要：目的探讨吻合浅静脉的邻指逆行指动脉Y～V血管蒂皮瓣修复手指软组织缺损的方法及临床效果。方法2009年3月至2011年6月，利用吻合浅静脉的邻指逆行指动脉Y—V血管蒂皮瓣修复20例手指近指间关节以远软组织缺损，其中示指12例，中指8例，皮瓣面积最大4．5cm×3．5cm，最小3．5cm×2．5cm，血管蒂长度平均4．0cm，均吻合一支浅静脉，缝接指背神经14例，供区全厚皮片植皮。结果20例皮瓣全部顺利成活，随访8～16个月，皮瓣外形及质地满意，缝接神经的两点辨别觉恢复至7—9mm，未缝接神经的感觉恢复至s2-s3，供区外形及功能无明显影响。结论邻指逆行指动脉Y—V血管蒂皮瓣可形成较长的血管蒂，修复近指问关节以远软组织缺损，通过吻合浅静脉可明显减轻皮瓣的静脉回流压力，提高皮瓣的成活质量，术后疗效满意。Objective To investigate the methods and results of reverse island flap of the adjacent digit pedicled with the Y-V vascular of digital artery by anastomosis of superficial veins for repairing soft tissue defects of the fingers. Methods From March 2009 to June 2011, twenty cases with soft tissue defect distal to the proximal interphalangeal join of fingers were treated by reverse island flap of the adjacent digit pedicled with the Y-V vascular of digital artery by anastomosis of superficial veins. There were 12 cases of the index finger, eight of middle finger, the largest area of the flaps was 4.5 cm x 3.5 era, and the smallest area was 3.5 cm x 2. 5 cm, an average of the pedical length was 4. 0 cm. All cases anastomosis one superficial vein, fourteen eases suture dorsal digital nerve, and the donor area covered with full-thickness skin graft. Results All flaps survived. Postoperative follow-up time ranged from 8 to 16 months, the appearance and texture of the flaps were excellent, the flaps with suture nerves, the two-point discrimination was 7 mm to 9 ram, the other flaps that the nerves were disconnected. The sensation of the flaps recovered to S2-S3 , no morbidity of the donor fingers occurred. Conclusion Reverse island flap of the adjacent digit pedicled with the Y-V vascular of digital artery by anastomosis of superficial veins can form a longer vascular pediele, to repair the soft tissue defect distal to the proximal interphalangeal joint, through anastomoses superfieial venous can reduce the flap venous pressure obviously, improve the survival quality of the flap, the effect is satisfaeted.

关 键 词：指 指动脉 指动脉皮瓣 静脉吻合 

分 类 号：R658.2[医药卫生—外科学]