断掌再植45例临床分析
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作者Author单位AddressE-Mail
颜飞华 YAN Fei-hua 新疆喀什地区第一人民医院, 新疆 喀什 844000  
廖军 LIAO Jun 新疆维吾尔自治区中医医院, 新疆 乌鲁木齐 830000 Xinjiang Uygur Autonomous Region Chinese Medicine Hospital, Urumqi 830000, Xinjiang, China LLZF8689@163.com 
单平联 SHAN Ping-lian 新疆喀什地区第一人民医院, 新疆 喀什 844000  
刘振峰 LIU Zhen-feng 新疆维吾尔自治区中医医院, 新疆 乌鲁木齐 830000 Xinjiang Uygur Autonomous Region Chinese Medicine Hospital, Urumqi 830000, Xinjiang, China  
方锐 FANG Rui 新疆维吾尔自治区中医医院, 新疆 乌鲁木齐 830000 Xinjiang Uygur Autonomous Region Chinese Medicine Hospital, Urumqi 830000, Xinjiang, China  
期刊信息:《中国骨伤》2014年,第27卷,第6期,第475-477页
DOI:10.3969/j.issn.1003-0034.2014.06.008
基金项目:新疆维吾尔自治区自然科学基金资助项目(编号:2011211A091)
中文摘要:目的: 探讨显微外科技术治疗断掌再植的方法及临床疗效。方法: 自2009年1月至2012年12月,采用显微外科技术急诊行断掌再植术治疗断掌患者45例,其中男37例,女8例;年龄13~45岁,平均25岁。术后采用存活率、中华医学会手外科学会上肢断肢再植功能评定试用标准对断掌再植功能恢复以及临床疗效进行评价。结果: 通过再植手术治疗断掌患者45例,共成活39例共121指,成活率为87%;45例患者均获随访,时间3~15.5个月,平均11.5 个月。中华医学会手外科学会上肢断肢再植功能评定试用标准总分80.27±1.93,其中优27例,良8例,差4例。结论: 严谨把握断掌再植手术的适应证,掌握断掌复杂性的特点以及局部解剖关系,术中做到清创彻底,残存组织利用充分,并结合显微外科技术尽快、最大程度地吻合动静脉,重建血液循环并使损伤的神经得到合理的修复是断掌再植成功的关键。
【关键词】显微外科手术  手掌  再植术
 
Clinical analysis on replantation of severed palm in 45 patients
ABSTRACT  Objective: To explore methods and clinical outcomes of microsurgical technique in treating patients with severed palm. Methods: From January 2009 to December 2012,45 patients with severed palm were treated by replantation through microsurgical technique,included 37 males and 8 females,aged from 13 to 45 years old with an average of 25. Postoperative survival rate and evaluation standard of upper limb replantation function posposed by Chinese Medical Association were applied for evaluate clinical outcomes after operation. Results: Forty-five patients with severed plam were treated by replantation. Thirty-nine patients(121 fingers) were survived,and survival rate was 87%. All patients were followed up 3 to 15.5 months with an average of 11.5 months. According to evaluation standard of upper limb replantation function posposed by Chinese Medical Association,the total score was 80.27±1.93,and 27 cases got excellent results,8 good and 4 poor. Conclusion: The success of replantation of severed palm depends on grasping operation indication strictly,knowing complexity and local anatomic relationship,debridement completely during operation,making full use of remaining organization,arteriovenostomy through microsurgical technique as early as possible,constructing circulation and repairing injuried nerve rationally.
KEY WORDS  Microsurgery  Metacarpus  Replantation
 
引用本文,请按以下格式著录参考文献:
中文格式:颜飞华,廖军,单平联,刘振峰,方锐.断掌再植45例临床分析[J].中国骨伤,2014,27(6):475~477
英文格式:YAN Fei-hua,LIAO Jun,SHAN Ping-lian,LIU Zhen-feng,FANG Rui.Clinical analysis on replantation of severed palm in 45 patients[J].zhongguo gu shang / China J Orthop Trauma ,2014,27(6):475~477
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