血管移植桥接在手指关节部位断指再植中的应用  

Application of blood vessel transplantation in replantation of severed finger in phalangeal joint

作　　者：吴信举 汤浩 谢久虎 朱自强 WU Xinju;TANG Hao;XIE Jiuhu(Department of Hand Surgery,The Second Affiliated Hospital of Xuzhou Medical University,Xuzhou,Jiangsu,221006,China)

机构地区：[1]徐州医科大学第二附属医院手外科,江苏徐州221006

出　　处：《实用手外科杂志》2021年第4期436-438,共3页Journal of Practical Hand Surgery

摘　　要：目的探讨血管移植桥接在手指关节处断指再植中的临床应用效果。方法2017年1月-2020年1月,对20例23指手指关节处断指再植行游离血管移植桥接术,术后随访,观察再植手指成活情况、外观满意度、指端感觉及关节活动度情况。结果20例23指再植中,22指成活良好,成活率达95%。1例因断指近端损伤严重,术后第4天再植断指远端颜色发暗坏死。全组术后随访6~12个月,平均9.5个月。末次随访,患者对再植手指外形、指端感觉及关节活动度比较满意,按中华医学会手外科学会断指再植功能评定试用标准评定,优良率达100%。结论在手指关节处的断指再植术中,清创去除损伤血管,行血管移植桥接治疗,不用短缩指骨行关节融合,术后手指外观及关节活动度恢复满意,治疗效果理想,值得临床推广。Objective To investigate the application value of blood vessel transplantation in replantation of severed finger at digital joint.Methods From January 2017 to January 2020,23 fingers of 20 patients with replantation of severed digital joints were selected for free blood vessel grafting and bridge.Follow-up was conducted on the patients after surgery to observe the survival of the replantated finger,appearance satisfaction,finger tip sensation and range of motion.Results Among 20 patients,22 fingers survived well,with a survival rate of 95%.One patient suffered severe proximal injury of the broken end,and the distal end of the finger was dark necrosis after replantation on the 4th day after operation.The patients were followed up for 6-12 months,with an average of 9.5 months.At the last follow-up,the patients were satisfied with the shape,finger tip sensation and range of motion of the replantation finger.The excellent and good rate was 100%according to the trial evaluation standard of replantation function of the amputated finger issued by Chinese Hand Surgery Society.Conclusion In the replantation of the severed finger at the digital joint,debridement and removal of the injured blood vessels should be performed,and the survival rate of the severed finger replantation is higher.After joint fusion without shortening the phalanx,the patient is satisfied with the appearance and range of motion of the finger,and vascular graft bridging for replantation of the severed finger at the joint has ideal therapeutic effect,which is worthy of clinical promotion.

关 键 词：血管移植 断指再植 关节部位 

分 类 号：R658.1[医药卫生—外科学]