静脉动脉化在手外科领域中的应用

Veno-arteriolization in the field of hand surgery successful ex- pansion

目的探讨静脉动脉化在断指再植、再造及皮瓣移植修复等方面的临床效果。方法手术治疗49例动脉条件特殊的患者，断指再植组21例，游离移植足趾再造手指组5例，皮瓣组23例，均采用静脉化动脉供札修复手指创面。结果除皮瓣组2例坏死外，其余手指均成活。患者均获随访，时间（4．5±0．6）个月、再植、再造组外观、功能满意；两点分辨觉：再植组为（9．5±0．5）mm，再造组为（10．5±1．0）mm。皮瓣组外观佳，无明显色素沉着，2-PD为（6．3±0．25）mm。3组病例均按TAM法评定：优42例，良5例，可2例，优良率为95．9％。结论静脉动脉化为手指再植、再造及皮瓣转移在动脉条件特殊、太差、或不牺牲动脉时可提供一种后备之法。

Objective To explore the clinical effect of Veno-arteriolization in digit replantation and re- construction and transplantation of flap. Methods All clinical data of 49 cases of vascular special condi- tions were divide which received surgical treatment, 21 eases in replantation group, 5 cases in reconstruction group, 23 cases in transplantation of flap group. All patients underwent veno- arterionlization. Results Two cases necrosis in transplantation of flap group, all the other fingers survived uneventfully. The patients were fldlowed up for （4.5 -＋0.6 ）months. The outcome was satistactory both functionally and cosmetically in re- plantation and reconstruction groups. 2-PD was （9.5 -＋0.5） mm in replantation group, 2-PD was （10.5 _＋ 1.0） mm in reconstruction group. The flaps had excellent appearance, good texture and color match in transplantation of flap group. According to the total active movement （TAM） evaluation system introduced by the American Society fi）r Surgery of the Hand in 1975, the results of this series showed excellent in 42 cases, good in 5 cases and fair in 2 cases, the excellent and good rate was 95.9%. Conclusions Veno-arteriol- ization was a new method for hand surgery trauma in specially circumstances. Owing to its simple procedure, reliable effect, it worth to be spreading.