足趾移植再造指尖部静脉重建问题探讨  

THE VENOUS RECONSTRUCTION OF FINGERTIPS WITH TOE TRANSPLANTATION

作　　者：胡春兰[1] 牟勇[1] 刘松波[1] 

机构地区：[1]广东省第二人民医院,广东广州510317

出　　处：《现代医院》2014年第9期31-32,共2页Modern Hospitals

摘　　要：目的探讨足趾移植再造指尖术式的静脉重建手术设计方法和发生静脉危象的关键因素。方法通过对新鲜足尸体标本进行显微解剖研究，观察足趾静脉分布、走形及管径大小，并探讨改善足趾移植再造甲根部以远指体术式静脉重建困难的手段；回顾性分析我院2008年1月～2012年12月收治的指尖部缺损再造病例，总结指尖部缺损再造术式静脉重建方法。结果本组足趾移植再造指尖部共37例48指，全部成活，其中有3例术后发生静脉危象，经手术探查或拆除部分伤口缝线成活，无动脉危象发生。结论足趾趾腹部静脉丰富，管径较大，变异小，术中吻合趾腹部2～3条静脉，可有效满足指尖部再造指体静脉回流需求，术后再造指体不容易发生静脉危象。Objective To explore the key factors of the design method of venous reconstruction of fingertip with toe transplantation and venous crisis. Methods Microdissection was performed on the fresh foot specimens to observe the distribution, shape and diameter of digital veins, and to improve the methods of venous reconstruction for fingertips with toe transplantation. The clinical data of cases of fingertip reconstruction selected from Jan. 2008 to Dec. 2012 were retrospectively analyzed to summarize the methods of venous reconstruction of fingertip. Results 37 cases with 48 fingers in this group survived. Among all cases, 3 cases had venous crisis after surgery but survived by surgical exploration or remove of partial wound sutures without arterial crisis. Conclusion Veins of toe abdomen are rich with larger diameters and lower variability. Anastomosis of 2 -3 veins in toe abdomen during operation can en- sure the venous return of reeonstructed fingertips to protect venous crisis in postoperative reconstructed fingers.

关 键 词：指尖部缺损 再造 静脉重建 显微外科 

分 类 号：R658.1[医药卫生—外科学]