静脉动脉化在手指末节离断伤再植中的疗效  

The effect of veno-arterialization in the replantation of severed distal phalanx of finger

作　　者：杨威[1] 张波[1] YANG Wei;ZHANG Bo(Dept of Traumatic Hand Surgery,the Second People′s Hospital of Nanning,Nanning,Guangxi 530023,China)

机构地区：[1]南宁市第二人民医院创伤手外科,广西南宁530023

出　　处：《临床骨科杂志》2021年第3期375-378,共4页Journal of Clinical Orthopaedics

摘　　要：目的探讨静脉动脉化在手指末节离断伤再植中的临床疗效。方法对17例手指末节离断伤患者采用静脉动脉化重建再植指体血运。观察血运延迟恢复时间、术后患指成活率、感觉恢复情况、远侧指间关节活动度、指甲生长情况以及外形。结果患者均获得随访,时间6~13个月。术后出现血运恢复延迟11指,发生率11/17,其中5~60 min恢复血运7例,61~120 min恢复血运4例。15指成活,2指坏死,成活率15/17。末次随访时,成活15指的痛、温觉恢复,两点辨别觉3.9~7.7(6.1±1.3)mm,远侧指间关节活动度56°~65°(61°±3°),指甲生长良好,外形满意。结论手指末节离断伤应用静脉动脉化的方法可以有效恢复再植指体血运,提高成活率,且成活患指感觉、活动度、指甲生长及外形恢复良好。Objective To investigate the clinical effect of veno-arterialization in the replantation of severed distal phalanx of finger.Methods The 17 patients with severed distal phalanx of finger were treated with veno-arterialization to reconstruct the blood circulation of replanted fingers.The following data were observed,including the delayed recovery time of the blood circulation,survival rate of the affected fingers,the recovery situation of sensation,activity of the distal interphalangeal joint,fingernail growth situation and its appearance.Results All cases were followed up for 6~13 months.The recovery of blood circulation in 11 fingers were delayed,the incidence rate was 11/17,of which 7 fingers recovered blood circulation within 5~60 min,and 4 fingers were within 61~120 min.The 15 fingers survived,2 fingers necrotized,the survival rate was 15/17.At the last follow-up,15 fingers recovered from pain and warm sense,and their two-point discrimination was 3.9~7.7(6.1±1.3)mm,and the activity of distal interphalangeal joint was 56°~65°(61°±3°),and the fingernails grew well,with the satisfied appearance.Conclusions Veno-arterialization can effectively recover the blood circulation of replanted severed distal phalanx of finger,and improve the survival rate,and the recovery of sensation,activity,fingernail growth and appearance of the affected fingers are good after operation.

关 键 词：手指末节离断伤 断肢再植 静脉动脉化 血运延迟恢复 

分 类 号：R658.1[医药卫生—外科学]