组合静脉移植在血管毁损性断指再植中的应用  

APPLICATION OF COMBINED VENOUS GRAFTING IN REPLANTATION OF VESSEL- DAMAGED SEVERED FINGERS

作　　者：关术[1] 李日绍[1] 林广宜[1] 余东[1] 张海武[1] 王自锋[1] 

机构地区：[1]茂名市人民医院,广东茂名525000

出　　处：《现代医院》2015年第9期61-63,共3页Modern Hospitals

摘　　要：目的探讨应用前臂掌侧及足部背侧的直型、树枝型浅静脉组合移植桥接血管毁损性断指，重建断指血循环的疗效。方法2004年1月～2014年12月，对98例患者共125个血管毁损性断指采用组合静脉移植的方法重建断指血循环，包括直型静脉倒置桥接动脉、树枝型静脉倒置桥接动脉、直型静脉及树枝型静脉顺行桥接指背静脉。结果108例血管毁损性断指获得存活，迟发性坏死断指17例，存活率86．4％。术后随访1～5年。未见再植指体坏死，皮温暖，指腹外观稍萎缩，指腹两点辨别觉6～10mm，关节活动度（TAM）比值（患侧／健侧）恢复至平均75．0％。结论采用组合静脉移植桥接血管毁损性断指重建血循环，可明显提高毁损性断指再植的存活率。Objective To investigate the curative effect of combined venous grafting with straight or branch - shaped superficial veins on forearm palmar side and dorsal foot in the replantation of vessel - damaged severed fingers and reestablishment of blood circulation of severed fingers. Methods 98 patients with a total of 125 vessel - damaged severed fingers admitted in our hospital from January 2004 to December 2014 were given combined venous grafting to rebuilt blood circulation which included straight vein inversely bridging artery, branch -shaped vein inversely bridg- ing artery and straight vein and branch - shaped vein directly bridging vein on the back of finger. Results A total of 108 cases of vessel- damaged severed fingers survived, and 17 cases experienced delayed necrosis with the survival rate of 86.4%. Follow - up visit of 1 to 5 years showed no necrosis on the replanted fingers, warm skin, mild shrink- age on the appearance of finger pulp, and two - point discrimination of finger pulp of 6 - 10 mm. The ratio of range of motion （ROM） （diseased side/healthy side） recovered to an average of 75.0%. Conclusion Combined venous grafting in replantation of vessel - damaged severed fingers and reestablishment of blood circulation can obviously im- prove the survival rate of severely - damaged fingers.

关 键 词：静脉移植 断指 再植 

分 类 号：R658.1[医药卫生—外科学]