单侧中央动脉吻合与指端创面放血法治疗YamanoⅠ区手指离断伤再植的效果对比研究  

Comparative study of unilateral central artery anastomosis and fingertip wound phlebotomy on amputated finger replantation in Yamano I area

作　　者：欧阳四民 赵景峰 林海阳 胡景宇 冯光 Ouyang Simin;Zhao Jingfeng;Lin Haiyang;Hu Jingyu;Feng Guang(Department of Repair and Reconstruction Surgery,Shougang Hospital,Peking University,Beijing 100144,China)

机构地区：[1]北京大学首钢医院修复重建外科,北京100144

出　　处：《血管与腔内血管外科杂志》2025年第2期257-260,265,共5页Journal of Vascular and Endovascular Surgery

摘　　要：目的对比单侧中央动脉吻合与指端创面放血法治疗YamanoⅠ区手指离断伤再植的效果。方法收集2021年9月至2023年9月于北京大学首钢医接受治疗的147例YamanoⅠ区手指离断伤再植患者的临床资料,依据手术方法的不同将其分为观察组(n=74,采用单侧中央动脉吻合)和对照组(n=73,采用指端创面放血法)。比较两组的围手术期指标、断指成活率;术后随访6个月,观察两组患者的断指指甲长度、两点辨别觉、远端指尖活动度,评价两组患者的断指恢复情况和手指关节活动度。结果观察组患者的术后住院时间短于对照组患者,换药频率少于对照组患者,断指成活率高于对照组患者,差异均有统计学意义(P﹤0.05)。术后6个月,观察组患者的断指指甲长度长于对照组患者,远端指尖活动度、断指恢复优良率和手指关节活动度优良率均高于对照组患者,两点辨别觉低于对照组患者,差异均有统计学意义(P﹤0.05)。结论相比于指端创面放血法,单侧中央动脉吻合治疗YamanoⅠ区手指离断伤再植的效果更显著,可缩短住院时间,减少换药频次,提高断指成活率,加快断指指甲生长,促进断指恢复,提高手指的关节活动度。Objective To compare the effect of unilateral central artery anastomosis and fingertip wound phlebotomy in the treatment of amputated finger replantation in Yamano I area.Method The clinical data of 147 patients with amputated finger replantation in Yamano I area who received treatment at Shougang Hospital,Peking University from September 2021 to September 2023 were collected.According to different surgical methods,they were divided into observation group(n=74,unilateral central artery anastomosis)and control group(n=73,fingertip wound phlebotomy).The perioperative indexes and survival rate of amputated finger were compared between groups.At 6 months of followup after surgery,the nail length of amputated finger,two-point discrimination and distal fingertip activity of the two groups were observed,and the recovery status of amputated finger and finger joint activity were evaluated.Result The postoperative hospitalization time of the observation group patients was shorter than that of the control group patients,the frequency of dressing change was less than that of the control group patients,and the survival rate of amputated finger was higher than that of the control group patients,and the differences were statistically significant(P<0.05).Six months after surgery,patients in the observation group had longer amputated finger nail length than those in the control group,the distal fingertip mobility,the excellent and good rate of amputated finger recovery,and excellent and good rate of finger joint activity were all higher in the observation group than those in the control group,the two-point discrimination was lower in the observation group than that in the control group,and the differences were statistically significant(P<0.05).Conclusion Compared with fingertip wound phlebotomy,unilateral central artery anastomosis is more effective in the treatment of amputated finger replantation in Yamano I area,and the latter one can better shorten the hospitalization time and dressing change frequency,improve the survival ra

关 键 词：YamanoⅠ区手指离断伤再植 单侧中央动脉吻合 指端创面放血法 断指成活率 恢复情况 手指关节活动度 

分 类 号：R543[医药卫生—心血管疾病]