摘要
目的 探讨断指再植后的临床疗效.方法 自2014年10月至2015年2月,共收治47例断指患者.麻醉后,在显微镜下对创面用双氧水进行彻底清创.适当缩短指骨,修剪血管,用克氏针固定骨折部位,将指动脉和指静脉进行吻合;若皮肤有缺损则采用带蒂皮瓣进行修复;指静脉不能吻合者,可将指甲拔除.结果 本组47例患者中,1例出现动脉危象,探查血管,重新进行吻合后好转;2指发生静脉危象,经小切口放血、抗凝、抗血栓治疗后成活.对42例患者随访6 ～12个月,成活指体辨别觉、痛觉,指间关节恢复良好,患者对术后效果满意.结论 断指发生后应尽快进行重植,在显微镜下行再植术具有安全、有效、术后成活率高的优点.
Objective To explore the effect of replantation of amputated finger. Methods From Oct. 2014 to Feb. 2015, 47 patients were accepted and treated in our department. After anesthetization, the wound was cleaned with hydrogen peroxide under microscope, then the phalanx was shortened appropriately and the blood vessel was clipped, after that the fracture was fixed with kirschner wire, finally the digital artery and digital vein were anastomosed. Pedicel flap was used to repair defect of skin if the skin was defective. The digital vein could not he anastomosed, so the finger nail would be removed. Results After operation, 47 patients were well except for one with arterial crisis which recovered after re-anastomosis and two patients with venous crisis which recovered after anticoagulant and antithrombotic therapies. After 6 to 12 months following up on 42 patients, all were satisfied with good function of joint and the senses of discrimination and pain. Conclusion Once amputa- tion occurrence, replantation will be done as soon as possible, the replantation performed under microscope is safe, effective with high survival rate.
出处
《中国美容整形外科杂志》
CAS
2015年第6期339-341,共3页
Chinese Journal of Aesthetic and Plastic Surgery
关键词
断指再植
显微镜手术
血管危象
Replantation of amputated finger
Micro-operation
Vascular crisis
作者简介
王佳琦（1989-），男，辽宁葫芦岛人，硕士研究生．
通信作者：张雪松，100853，解放军总医院骨科，电子信箱：zhangxuesong301@sina．com
