不吻合静脉的指尖再植34例临床治疗  

Fingertip replantation without venous anastomosis:34 cases report

作　　者：薛孝威 韩婷[2] 顾加祥 张乃臣 刘宏君 张文忠 XUE Xiaowei;HAN Ting;GU Jiaxiang(Department of Hand and Foot Surgery,Northern Jiangsu People's Hospital Affiliated To Yangzhou University,Yangzhou,Jiangsu,225000,China)

机构地区：[1]扬州大学临床医学院苏北人民医院手足外科,江苏扬州225000 [2]扬州大学广陵学院,江苏扬州225127

出　　处：《实用手外科杂志》2018年第4期426-428,共3页Journal of Practical Hand Surgery

摘　　要：目的探讨不吻合静脉指尖再植的临床疗效。方法 2016年1月-2018年5月对34例37指指尖离断进行再植术,仅吻合指动脉终末支,不吻合静脉,术后选择性进行放血治疗。结果 33指再植成活,4指失败,成活率89.2%。术后随访3～21个月,再植指体外形饱满27指,6指指甲出现不同程度畸形,4指指体出现轻度萎缩,指腹两点辨别觉5～14 mm,再植指功能恢复良好。结论保证吻合血管质量,提高吻合技术,不吻合静脉的指尖再植、选择性进行放血治疗,也可取得较高的再植成活率。Objective To explore the clinical effect of fingertip replantation without venous anastomosis.Methods From January 2016 to May 2018,34 cases with 37 severed fingertips underwent replantation,anastomosing only the terminal finger of the digital artery,without venous anastomosis,and selectively bleeding after operation.Results Thirty-three replantation fingers survived,4 fingers failed,and survival rate was 89.2%.All patients were successfully followed up for 3 to 21 months.At the final followed-up,27 fingers had full pulp,6 fingernails were deformed,and 4 cases had mild atrophy of finger.Two point discrimination ranged from 5 to 14 mm,and the function of replanted finger recovered well.Conclusion It can also achieve higher survival rate of replantation,that ensuring the quality of blood vessel,improve the anastomosis technique,replantation of fingertips without vein anastomosis and selective bleeding therapy.

关 键 词：指尖 指再植 指损伤 

分 类 号：R658.1[医药卫生—外科学]