掌侧动脉静脉化血管吻合与背侧静脉血管吻合在末节断指再植中的应用效果  

Application effect of palmar artery venous anastomosis and dorsal venous anastomosis in replantation of severed finger

作　　者：曹浩 李政 唐加波 王鹏 CAO Hao;LI Zheng;TANG Jiabo;WANG Peng(Department of Traumatic Hand Surgery,Zhenjiang First People's Hospital,Jiangsu Province,Zhenjiang 212000,China)

机构地区：[1]江苏省镇江市第一人民医院创伤手外科,江苏镇江212000

出　　处：《中国当代医药》2025年第8期38-41,共4页China Modern Medicine

摘　　要：目的探讨掌侧动脉静脉化血管吻合与背侧静脉血管吻合在末节断指再植中的应用效果。方法回顾性分析2022年1月至2024年1月镇江市第一人民医院收治的100例末节断指患者的临床资料,按治疗方式不同分为A组(50例)和B组(50例),A组行掌侧动脉静脉化血管吻合,B组行背侧静脉血管吻合。比较两组断指成活率、断指功能、断指血运、疼痛程度、并发症。结果两组断指成活率比较,差异无统计学意义(P>0.05)。A组断指功能优良率高于B组,差异有统计学意义(P<0.05)。A组再植指经皮氧分压(TcPO_(2))、氧饱和度高于B组,断指微循环检测值低于B组,毛细血管充盈时间(CRT)短于B组,差异有统计学意义(P<0.05)。A组术后6、12、24 h时视觉模拟评分法(VAS)评分均低于B组,差异有统计学意义(P<0.05);两组并发症总发生率比较,差异无统计学意义(P>0.05)。结论末节断指再植使用两种吻合方式均能获得较高的成活率且安全性相似,但掌侧动脉静脉化血管吻合可更好改善断指血运,提高断指功能,减轻患者疼痛程度,值得临床推广。Objective To explore the application effect of palmar artery venous anastomosis and dorsal venous anastomosis in replantation of severed finger.Methods The clinical data of 100 patients with severed fingers admitted to Zhenjiang First People's Hospital from January 2022 to January 2024 were retrospectively analyzed,and they were divided into group A(50 cases)and group B(50 cases)according to different treatment methods.Group A received volar artery venous anastomosis,and group B received dorsal venous anastomosis.The survival rate,function,blood flow,pain degree and complications of severed finger were compared between the two groups.Results There was no significant difference in the survival rate of severed finger between the two groups(P>0.05).The excellent and good rate of broken finger function in group A was higher than that in group B,and the differences were statistically significant(P<0.05).The transcutaneous oxygen partial pressure(TcPO_(2))and oxygen saturation of reimplanted fingers in group A were higher than those in group B,the microcirculation detection value of broken fingers was lower than that in group B,and the capillary filling time(CRT)was shorter than that in group B,the differences were statistically significant(P<0.05).Visual analogue scale(VAS)scores in group A were lower than those in group B at 6,12 and 24 h after surgery,with statistical significances(P<0.05).There was no significant difference in the total incidence of complications between the two groups(P>0.05).Conclusion The replantation of severed finger with both anastomosis methods can achieve a higher survival rate and similar safety,but palmar artery venous vascular anastomosis can better improve the blood flow of severed finger,improve the function of severed finger,and reduce the pain degree of patients,which is worthy of clinical promotion.

关 键 词：末节断指 掌侧动脉静脉化血管吻合 断指再植 断指功能 背侧静脉血管吻合 

分 类 号：R264[医药卫生—中医外科学]