海水浸泡后旋转撕脱性断指再植促成活的护理

Nursing of replantation of sea-water soaked rotated avulsion amputated fingers

目的探讨海水浸泡后旋转撕脱性断指再植促成活护理措施。方法我院共收治8例（16指）海水浸泡后旋转撕脱性断指患者，多指离断采用同步法再植5例，其他3例采用传统方法再植。术中运用彻底清创，高质量的血管吻合，术后高压氧治疗及综合抗凝措施进行救治。结果16个再植手指中成活15指，总成活率为93．75％。术后随访3个月～2年，总优良率为87．5％。无伤口感染及骨折不愈合病例发生。手指外形满意，感觉恢复良好，两点辨别觉3-6mm。结论海水浸泡后旋转撕脱性断指伤情复杂，再植难度大，但是只要根据实际情况，采取个体化综合应对措施，再植指体完全可以成活。

Objective To investigate the nursing of replantation methods of sea-water soaked rotated avulsion amputated fingers. Methods There were 8 cases （16 fingers） with sea-water soaked rotated avulsion amputated fingers. 5 cases were replanted by synchronic replantation method, the other 3 cases were replanted by traditional replantation method. We adopted complete debridement and high quality vascular anastomosis during the operation, and give hyperbaric oxygen therapy and anticoagulant treatment post-operation. Results There were 15 survival fingers in 16 replanted fingers. The survival rate was 93.75%. After follow-up for three months to two years, the total good rate was 87.5%. No wound infection and nonunion of fracture occurred. The outline of the fingers was satisfying and patients felt well. The twopoint discrimination was 3-6 mm after 3-24 months follow-up. Conclusions The injury of sea-water soaked rotated avulsion amputated fingers is complicated and the replantation operation is difficult, but if we can adopt individual measure according to the actual circumstance, it is possible that the sea-water soaked rotated avulsion amputated fingers can survive.