断指再植52例临床体会

Clinical effect of 52 cases of finger replantation

目的分析52例断指再植的治疗体会。方法分析2007年1月至2012年4月进行断指再植的52例患者59指,在手术显微镜下彻底清创、精确吻合血管,仔细修复肌腱及指神经。术后常规行"三抗"治疗与早期康复治疗。对其治疗效果进行分析。结果本组术后发生动脉危象2指,采用治疗后再植手指成活。本组52例59指术后经6～12个月随访,59指坏死1指,成活率98.3%,其余再植手指均有良好的外形及功能,指间关节有较好的屈伸活动度。按中华医学会手外科学会制定的功能评定试用标准:优47指,良11指,差1指,优良率98.3%。结论断指再植术中精确无误的血管吻合,术后血管危象的防治是再植成功的关键,早期康复锻炼是断指术后获得良好功能的重要环节。

Objective To analyze the clinical efficacy of the 52 cases of finger replantation. Methods Since 2007 ,finger replantations were performed in 52 patients involving with 59 fingers in our hospital. For finger replantation, debridement, precise vascular anastomosis, careful repair of tendon and nerve were conduc- ted. Patients received antibiotic therapy and took early rehabilitation therapy following operation. Results A- mong 59 cases of replantation-58 cases survived,with success rate of 98.3%. The length of follow-up ranged from 6 to 12 months. According to the evaluation criteria of replantation assessment,the excellent and good rate was 98.3%. The repaired fingers were observed good appearance and normal function. Conclusion With the development of microsurgieal technique, active choice of replantation methods and systemic use of postoperative drugs have significantly improved the success rate. The key points of finger replantation are to conduct thorough debridement and perfoim good vascular anastomosis under operating microscope.