多手指离断再植方法的改进与应用

Augmentation and clinical application of replantation of severed multi-fingers

目的探讨多指离断的再植方法和疗效。方法对146例（337指）多指离断患者运用同步法进行再植，其方法是对手术进程优化组合，将多个断指同一类的操作尽量一次完成，相同的操作同步进行。同一掌（背）面的操作尽量一次完成，避免频繁翻转患手及大幅度调整显微镜，减少各种物理刺激。结果337个再植手指中成活321指，总成活率为95．3％。302指术后随访12～28个月，平均16．4个月。所有成活手指外形满意，感觉恢复良好。结论同步法再植是对手术进程优化组合，采用程序化再植技巧进行再植，操作步骤简化，明显地缩短了再植手术时间，极大地提高了工作效率。

Objective To investigate the replantation method and its curative effect for severed multi-fingers. Methods There were 146 cases （337 fingers） replanted by synchronic replantation that improved the operation progress. During replantation, more attention should be paid to avoid regular turnover of hands, large - extent adjustment of the microscope and decrease of physical stimulations. Resuits Of 337 replanted fingers, 321 fingers survived, with survival rate of 95.3%. A total of 302 fingers were followed up for 12-28 months （mean 16.4 months）, which showed that all survived fingers had satisfactory outlines and sound sensory recovery. Conclusion The synchronic replantation optimizes oper- ation process and is characterized by simple operation, short operation time and high efficiency.