仅吻合动脉的手指末节Yamano Ⅰ区断指再植  

Replantation of fingertip amputation in Yamano Ⅰ zone with only artery anastomosis

作　　者：孙大炜[1] 刘晓春[1] 吴伟炽[1] 黄国英[1] 祝李霖[1] 兰万利 黄东[1] 

机构地区：[1]广东省第二人民医院创伤显微外科,广东广州510317

出　　处：《实用手外科杂志》2016年第2期144-146,共3页Journal of Practical Hand Surgery

基　　金：广东省自然科学基金资助面上项目（项目编号：S2013010012215）

摘　　要：目的 探讨仅吻合动脉在手指末节Yamano Ⅰ区断指再植中的临床疗效.方法 收治28例（36指）Yamano Ⅰ区手指末节离断再植病例,术中仅吻合1～2条指尖动脉,术后常规“三抗”治疗,并观察再植指血运情况.结果 28例（36指）术后成活34指,21指出现血管危象,给予甲床放血结合指尖放血处理后危象解除,2例（3指）拒绝行探查术,逐渐出现干性坏死,成活率为91.67％.术后随访3～12个月（平均8.5个月）,成活指外形满意,感觉恢复良好,按断指再植评分标准均为优.结论 手指末节Yamano Ⅰ区断指再植,仅吻合动脉,手术操作简便,临床效果满意.Objective To investigate the replantation of fingertip amputation in Yamano Ⅰ zone with only artery anastomosis. Methods 36 fingertips in YamanoⅠ zone in 28 cases received replantation with only 1 2 artery anastomosed in each fingertip during operation. Routine ＂anti-infection, anti-coagulation, anti- vasospasm＂ treatment was applied and the blood supply of replanted fingertip was observed after the surgery. Results 34 replanted fingertips survived with survival rate of 91.67%, followed up for 3- 12 months （an average of 8.5 months）. The survivals had satisfying appearance and sensory which were evaluated according to the criteria for functional assessment of amputated finger issued by the Branch of Hand Surgery of Chinese Medicine Association. In this group, 21 fingertips occurred vascular crisis postoperative, and then were given raising the limbs, nail beds bloodletting. 2 patients （3 replanted fingertips） gradually got dry necrosis because of the patients refused to surgical exploration again. Conclusion Replantation of fingertip amputation in Yamano I zone with only artery anastomosis has a good curative effect, specifically in double arteries anastomosis group.

关 键 词：手指末节 Yamano Ⅰ区 断指再植 

分 类 号：R658.1[医药卫生—外科学]