显微外科技术在20例多指离断再植中的应用  

Application of microsurgical technique in replantation of 20 cases with multiple severed fingers

作　　者：宋文斌 郑晓菊 郑宇棋 杨博 刘鑫 SONG Wen-bin;ZHENG Xiao-ju;ZHENG Yu-qi;YANG Bo;LIU Xin(Hand and Foot Microsurgery Department, Xi'an Fengcheng Hospital, Xi'an 710016, China)

机构地区：[1]西安凤城医院手足显微外科

出　　处：《临床医学研究与实践》2019年第26期69-71,共3页Clinical Research and Practice

摘　　要：目的探讨显微外科技术在20例多指离断再植中的应用。方法选取我院20例多断指(70指)患者为研究对象,2例指尖离断采取原位再植,3例甲根以远采取吻合动脉血管1~2根、甲床放血,15例采取按比例吻合动静脉血管。分析所有患者的治疗效果。结果再植指体完全一期存活18例,1例其中1断指发生静脉血管危象,血管危象探查后存活;1例发生1断指坏死,解脱后采用皮耐克覆盖创面,保留了指体长度。术后平均随访6个月,患指活动优15例,良2例,中2例,差1例,优良率为85.0%。患指感觉分级,S4级12例,S3+级4例,S3级2例,S2级1例,S1级1例。结论利用显微外科技术完成多断指再植,可最大限度保留各指体完整,临床效果较好。Objective To investigate the application of microsurgical technique in replantation of 20 cases with multiple severed fingers. Methods Twenty patients with multiple severed fingers (70 fingers) in our hospital were selected as the study objects. Two cases of fingertip amputation were replanted in situ, 3 cases of distal nail root were anastomosed with 1- 2 arterial vessels and nail bed bleeding was given, and 15 cases were anastomosed with arteriovenous vessels proportionally. The therapeutic effect of all patients were analyzed. Results The replanted fingers survived completely in one stage in 18 cases, of which one severed finger in one case had venous and vascular crisis and survived after vascular crisis exploration;one severed finger necrosis occurred in one case, and the wound was covered by Pelnac after liberation, and the length of finger body was retained. The average follow-up period was 6 months. The excellent and good rate was 85.0%, including 15 cases with excellent finger movements, 2 cases with good finger movements, 2 cases with medium finger movements and 1 case with poor finger movements. Among the sensory grading of affected fingers, there were 12 cases of grade S4, 4 cases of grade S3+, 2 cases of grade S3, 1 case of grade S2 and 1 case of grade S1. Conclusion The replantation of multiple severed fingers can be completed by microsurgical technique, and the integrity of finger body can be preserved to the maximum extent with good clinical results.

关 键 词：多指离断 断指再植术 显微外科技术 

分 类 号：R658.1[医药卫生—外科学]