摘要
目的 总结 2年来的断指再植经验 ,报道甲根部断指再植的临床效果。 方法 手术时寻找断端两侧动脉、神经 ,顺行吻合一侧动脉 ,小心解剖动脉弓 ,结扎从动脉弓发出的分支 ,仅保留一条至中央的较细分支 ,以减少进入指尖的血液量 ,再吻合两侧指神经 ,不吻合静脉。 结果 再植 2 5例 ,其中 13例术后指尖色泽红润 ,成活顺利。 12例术后轻度暗紫 ,经指尖指刺放血 ,9指指尖逐渐正常 ,成活良好 ,余 3指暗紫未减轻 ,行侧切口放血 ,2指成活 ,1指坏死。 结论 对甲根部断指再植手术 ,只吻合一侧动脉 ,而不吻合静脉也能成活。但要结扎从动脉弓发出的大部分分支 ,仅保留一条至中央的较细分支 ,从而减少指端的供血量 ,可达到减少术后淤血 ,能提高其治愈率。
Objective To evaluate the experience of replantation of severed finger tip and suggest a new method to replant the severed finger tip injury. Methods A total 25 cases of severed finger tip injuries on nail root level were retrospectively analysed.They were 18 males and 7 females,19～38 years old.The finger tips were completely cut down.The wound should be cleaned thoroughly under operative microscope and the cut ends of artery and nerve can be found on the wound.The important step was to dissect out all braches of the arch of the artery and ligate them but one small branch,so as to reduce the blood circulate into the finger tip.It was not necessary to joint the vein. Results Twenty-four fingers were survived,only one finger was necrosed.The course of 13 fingers were very prosperous.Twelve fingers had some cyanosis and 9 fingers turned red after a few punctures to release the venous blood and other 3 fingers should make a side incision torelease more venous blood.Then 2 fingers were survived and one finger was failured. Conclusion Only one artery should be anastomos for finger tip injury on nailroot level.No vein should be joint.But the branches of the artery arch should be ligated except one small branch.
出处
《中华显微外科杂志》
CSCD
北大核心
2004年第3期175-176,共2页
Chinese Journal of Microsurgery
