指固有动脉静脉化在断指再植中的应用  

Application of venous proper digital artery in replantation

作　　者：王福星[1] 叶建华[1] 唐桂阳[1] 王鹏[1] 刘雄华 田家勇[1] 赖锋文 蔡明帝 

机构地区：[1]中国人民解放军第196医院创骨中心,广东湛江524034 [2]阳江博爱医院手足外科,广东阳江529500

出　　处：《实用手外科杂志》2016年第4期467-468,共2页Journal of Practical Hand Surgery

摘　　要：目的 总结一侧指固有动脉静脉化在断指及复合组织瓣再植中的应用经验.方法 2012年3月-2014年9月,对22例30指断指及14例16块复合组织瓣行再植术,术中均予一侧动脉静脉化.结果 1指于远侧指间关节处离断,行再植术,非优势侧动脉静脉化,因指体挫伤严重,术后动脉一直供血不足,第3天坏死;2块复合组织瓣再植,同样行一侧动脉静脉化,术后皮缘部分坏死,经换药后愈合.其余指体及复合组织瓣均顺利成活,伤口Ⅰ期愈合.所有病例随访6-18个月,功能恢复满意,指体无明显萎缩.结论 在断指及复合组织瓣再植中,当远端无可供吻合的静脉时,临床一般都是通过“放血”疗法来解决静脉回流问题.如应用一侧指动脉静脉化之后,则无静脉回流障碍之忧,可显著提高再植成活率.Objective To summarize the clinical experience of unilateral venous artery in application of composite tissue flap replantation and severed finger. Methods Replantation was applied in 22 cases with 30 severed fingers and 14 cases with 16 combined tissue flaps, with unilateral venous artery during March 2014 - September 2012. Results 1 finger with distal interphalangeal joints severing, was replanted, venous artery was at non-dominant side, the finger had insufficiency blood supply after operation, and necrosis occured on the third day because of serious contusion in the finger body. 2 pieces of composite tissue flap replantation, with unilateral venous artery, the edge of the skin had necrosis after operation, healed after dressing change. The rest of the replanted fingers body and composite tissue flaps survived, the wounds healed primarily. All patients were followed-up for 6 to 18 months, function recovered satisfactorily, finger body had no obvious atrophy. Conclusion In the replantation of severed finger and composite tissue flaps, when the distal end of the vein is not available, the venous reflux is solved through “bloodletting” therapy. With unilateral venous artery, the venous reflux exist, it can increase the survival rate of replantation.

关 键 词：断指再植 复合组织瓣再植 动脉静脉化 

分 类 号：R331.3[医药卫生—人体生理学]