467例734个复杂性断指再植方法的选择与探讨  

Selection and investigation on replantation of 734 complicated amputated fingers in 467 cases

作　　者：陈福生[1] 李军[1] 林彬[2] 付彦春[1] 王茂荣[1] 姚世新[1] 谷云峰[1] 

机构地区：[1]温州市中医院手外科中心,325000 [2]解放军第四○一医院手外科

出　　处：《中华手外科杂志》2003年第3期139-141,共3页Chinese Journal of Hand Surgery

摘　　要：目的　探讨复杂性断指的分型及再植方法。方法　对 467例 73 4个复杂性断指依照伤情和术式结合的方法进行分类。对旋转性断指、脱套性断指、多节段性断指、伴皮肤神经血管缺损的断指、伴部分复合组织块缺损的断指、指尖离断及多指离断 ,分别采用不同的方法进行再植。结果　 73 4个断指再植后存活 72 1指 ,存活率达 98.3 %。术后随访到 418例 ,共随访 6～ 13个月。以最后 1次随访结果为准 ,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 2 84例 ,良 95例 ,差 3 9例 ,优良率达到90 .7%。结论　复杂性断指的再植方法各异 ,正确判断伤情 ,选择最佳的手术方案是保证手术成功的重要前提。Objective To investigate the replantation methods and classification of complicated amputated fingers. Methods According to the injury mechanism and replantation methods, 734 complicated amputated fingers in 467 cases were classified. The proper surgical methods were chosen for replantation of rotated amputated finger, degloving amputated finger, multiple level finger amputation, finger amputation with defect of skin, nerve and vessel, finger amputation with partial composite tissue defect, finger tip amputation and multi-finger amputation. Results Of 734 complicated amputated fingers, 721 survived with the successful rate 98.3%. Regular follow-ups were done in 418 cases with a period of 6 to 13 months. According to the criteria for functional assessment of amputated finger issued by the Branch of Hand Surgery of Chinese Medicine Association, the last follow-up result as excellent in 284 cases, good in 95 cases and poor in 39 cases. The excellent and good rate was 90.7%. Conclusion Although there were different replantation procedures, it was utmost for successful surgical results to correctly estimate the injury degree and accordingly select the ideal operation method.

关 键 词：断指再植 手术方法 术式选择 分型 旋转性断指 脱套性断指 多节段性断指 

分 类 号：R658.1[医药卫生—外科学]