多点中心定位法在细小异物取出术中的应用

RESEARCH AND APPLICATION OF MULTIPOINT CENTRALIZATION METHOD IN REMOVAL OF SMALL FOREIGN BODY

目的探讨多点中心定位法在手足部细小异物取出术中的可行性及疗效。方法 2007年5月-2012年3月,收治手足部细小异物存留患者78例。男51例,女27例;年龄7~69岁,平均32.5岁。手部48例,腕部6例,足部24例。异物类型:玻璃纤维57例,木刺11例,铁屑5例,竹刺2例,鱼刺2例,金属针头1例。受伤至就诊时间为30 min^16 d,平均2.6 d。异物取出术前,首先定位最痛点,以其为中心点呈辐射状向周围触压皮肤至无触痛点,连接无痛点形成圆形即为异物位置范围。按照该范围,在显微镜下寻找异物。结果异物均顺利完整取出;手术时间3~22 min,平均6 min。术后切口均Ⅰ期愈合,皮瓣无血运障碍,无感染发生。患者均获随访,随访时间3个月~3年,平均9个月。切口局部及其远端肢体无感觉或运动障碍。结论异物取出术中应用多点中心定位法确定异物范围,操作简便可行,取出成功率高,可获得满意疗效。

Objective To introduce a new method to remove the small foreign body in the hand or foot, and to discuss its feasibility and effectiveness. Methods Between May 2007 and March 2012, 78 patients with small foreign bodies embedded in the soft tissue of the hand or foot were treated with the method. There were 51 males and 27 females, aged from 7 to 69 years with an average of 32.5 years. The hand, wrist, and foot were involved in 48, 6, and 24 cases respectively. Foreign body type included fiberglass （57 cases）, thorn （11 cases）, iron （5 cases）, bamboo thorn （2 cases）, fishbone （2 cases）, and metal needles （1 case）. The time between injury and operation was 30 minutes to 16 days （mean, 2.6 days）. The position and range of the foreign body were defined using the multipoint centralization method before removal surgery. The skin was cut according multipoint connection for finding small foreign body under a microscope. Results All foreign bodies were successfully removed. The mean operation time was 6 minutes （range, 3-22 minutes）. Healing of incision by first intention was obtained in all cases; no blood circulation disorders or infection occurred. All the patients were followed up 3 months-3 years （mean, 9 months）. The distal limb had no feeling or movement disorders. using multipoint centralization method is safe and effective. Conclusion Removal of small foreign body in soft-tissue