| 缺乏可供吻合静脉的指尖离断再植方法选择 |
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Received:January 13, 2012
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| 作者 | Author | 单位 | Unit | E-Mail |
| 卫建民 |
WEI Jian-min |
宝鸡市中医医院手外科, 陕西 宝鸡 721000 |
Department of Hand Surgery, Traditional Chinese Medical Hospital of Baoji, Baoji 721000, Shaanxi, China |
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| 孙军锁 |
SUN Jun-suo |
宝鸡市中医医院手外科, 陕西 宝鸡 721000 |
Department of Hand Surgery, Traditional Chinese Medical Hospital of Baoji, Baoji 721000, Shaanxi, China |
dr.sunjunsuo@163.com |
| 焦小虎 |
JIAO Xiao-hu |
宝鸡市中医医院手外科, 陕西 宝鸡 721000 |
Department of Hand Surgery, Traditional Chinese Medical Hospital of Baoji, Baoji 721000, Shaanxi, China |
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| 景斗星 |
JING Dou-xing |
宝鸡市中医医院手外科, 陕西 宝鸡 721000 |
Department of Hand Surgery, Traditional Chinese Medical Hospital of Baoji, Baoji 721000, Shaanxi, China |
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| 何伟 |
HE Wei |
宝鸡市中医医院手外科, 陕西 宝鸡 721000 |
Department of Hand Surgery, Traditional Chinese Medical Hospital of Baoji, Baoji 721000, Shaanxi, China |
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| 靳文阔 |
JIN Wen-kuo |
宝鸡市中医医院手外科, 陕西 宝鸡 721000 |
Department of Hand Surgery, Traditional Chinese Medical Hospital of Baoji, Baoji 721000, Shaanxi, China |
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| 陈时高 |
CHEN Shi-gao |
宝鸡市中医医院手外科, 陕西 宝鸡 721000 |
Department of Hand Surgery, Traditional Chinese Medical Hospital of Baoji, Baoji 721000, Shaanxi, China |
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| 期刊信息：《中国骨伤》2012年25卷，第8期，第648-650页 |
| DOI：10.3969/j.issn.1003-0034.2012.08.008 |
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目的:探讨缺乏可供吻合静脉的指尖离断再植方法。
方法:自2004年11月至2009年11月,对86例104指指尖离断患者进行再植,其中男64例,女22例;年龄2～64岁,平均26岁。伤后至就诊时间30 min～12 h,断指缺血时间2.5～12 h,术前各项检查均未见明显异常。采用4种再植方法:①吻合双侧指固有动脉,指根部结扎一侧指固有动脉的断指再植,37指;②动-静脉转流方式的断指再植,27指;③只吻合指动脉的断指再植,24指;④去表皮囊袋法再植,16指。
结果:86例104指,成活102 指,伤指成活病例中75 例(92 指)获得随防,时间6～24个月。按中华医学会手外科学会断指再植术后功能评定试用标准评定:优52 例,良19 例,差4 例。
结论:依据显微镜下清创所见离断指尖动脉损伤状况,选用不同的再植方式,有助于扩大指尖再植适应证,提高再植成功率。 |
| [关键词]:指损伤 软组织损伤 静脉 再植术 |
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| Replantation of fingertip amputation in lack of availability of intravenous anastomosis |
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Abstract:
Objective:To discuss the replantation of fingertip amputation in lack of availability of intravenous anastomosis.
Methods:From November 2009 to November 2010,86 patients(104 fingers) with fingertip amputation were treated with replantatioin,including 64 males and 22 females,with an average age of 26 years ranging from 2 to 64 years. The time from injury to therapy was from 30 min to 12 h,time of broken finger ischemia was from 2.5 to 12 h. Preoperative examination showed no obvious abnormalities. Four different replantation methods were selectively applied to these 104 amputated fingertips of 86 cases:①replantation with anastomosis of single or bilateral proper digital artery in 37 fingers;②replantation with arteriovenous bypass in 27 fingers;③replantation with exclusive anastomosis of digital artery in 24 fingers; ④replantation with removing the palmar pocket method in 16 fingers.
Results:One hundred and two of 104 amputated fingertips were survived. Among these survived fingers,75 cases(92 fingers) were followed-up for 6 to 24 months. According to the assessment standard of Chinese Medical Association of Hand Surgery,the results were excellent in 52 cases,good in 19,poor in 4.
Conclusion:It benefits to expand the indications and improve the survival rate of replantation of fingertip amputation with the correct choice of different replantation methods according to the injury situation of the broken fingertip artery after debridement under the microscope. |
| KEYWORDS:Finger injuries Soft tissue injuries Veins Replantation |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 卫建民,孙军锁,焦小虎,景斗星,何伟,靳文阔,陈时高.缺乏可供吻合静脉的指尖离断再植方法选择[J].中国骨伤,2012,25(8):648~650 |
| 英文格式: | WEI Jian-min,SUN Jun-suo,JIAO Xiao-hu,JING Dou-xing,HE Wei,JIN Wen-kuo,CHEN Shi-gao.Replantation of fingertip amputation in lack of availability of intravenous anastomosis[J].zhongguo gu shang / China J Orthop Trauma ,2012,25(8):648~650 |
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