前臂复杂毁损性不全离断伤的再植修复效果分析  

Effect analysis of replantation operation in treatment of forearm complex destructive incomplate amputation injury

作　　者：孙荣涛[1] 焦涛[1] SUN Rongtao;JIAO Tao(Department of Hand Surgery,Laiwu Central Hospital of Xinwen Mining Group,Laiwu,Shandong,271103,China)

机构地区：[1]新汶矿业集团莱芜中心医院手足外科,山东莱芜271103

出　　处：《实用手外科杂志》2018年第2期159-162,共4页Journal of Practical Hand Surgery

摘　　要：目的探究前臂复杂毁损性不全离断伤的再植修复效果及治疗体会。方法选取2010年1月-2015年5月收治的前臂复杂毁损性不全离断伤52例,均急诊行前臂短缩再植及手功能修复重建术,术后给予规范化的康复训练,现对患者临床资料作回顾性分析。结果所有患者顺利完成手术,手术时间3～8 h,平均(6.5±1.7)h,术中出血量187～432 mL,平均(265.3±56.2)mL。52例离断肢体全部成活,随访时间18～36个月,平均(24.2±6.5)个月。术后18个月,52例患者手部功能和本体感觉均有不同程度恢复,肢体功能:Ⅰ级18例,Ⅱ级22例,Ⅲ级12例。结论对于前臂复杂毁损性不全离断伤,早期行前臂短缩再植及手功能重建术是断肢成活的关键,术后规范化康复训练有利于最大程度恢复肢体功能。Objective To explore the effect and treatment experience of replantation operation in treatment of forearm complex destructive incomplate amputation injury. Methods Fifty-two cases of patients with forearm complex destructive incomplate amputation injury treated in our hospital from Jan 2010 to May 2015 were selected. They were 34 males, 18 females; age from 25 to 67 years old, with the average （31.2± 5.6） years; 16 cases for rotational avulsion injury, 24 cases for crush injury; 12 cases for hot cutting damage. All patients were given replantation of forearm shortening, repair and reconstruction of hand function and rehabilitation training. The clinical data was analyzed retrospectively. Results All patients completed surgeries successfully, operation time was 3-8 h, average （6.5±1.7） h; intraoperative blood loss was 187- 432 mL, average （265.3±56.2） mL. All 52 cases of amputated limb survived, follow-up time was 18-36 months, average （24.2±6.5） months. 18 months after operations, all 52 cases of limbs had different levels of recovery, limbs function： 18 cases for level I, 22 cases for level II, 12 cases for level III. Conclusion As for forearm complex destructive imcomplete amputation injury, it is the key to replantat and shorten the forearm, repair and reconstruc hand function early. The standardized rehabilitation training after operation can benefit to the maximum recovery of limb function.

关 键 词：离断伤 断肢再植 前臂 功能训练 

分 类 号：R658.1[医药卫生—外科学]