断指再植过程中血管缺损的处理

Management of vessel defect in finger replantation

目的 探讨断指再植过程中血管缺损的处理方法。方法 采用血管转位、血管移植修复长段血管缺损 ;合并有软组织缺损的采用带血管的微型皮瓣修复 ;末节及指尖无静脉缝合时 ,通过增加离断指体间接触面积进行再植。结果 修复 136指 ,成活 112指。随访 1～ 2年 ,关节活动功能 :优4 2指 ,良 5 0指 ,差 2 0指 ;感觉恢复程度 :优 4 5指 ,良 5 1指 ,差 16指 ;血液循环 :优 6 4指 ,良 4 8指 ;再植指外观 :优 6 2指 ,良 34指 ,差 16指。结论 血管缺损的断指修复应根据具体伤情 ,采用灵活的手术方法 。

Objective To explore the methods of managing vessel defect in the process of finger replantation. Methods Vessel displacement and vessel implantation were used to repair long distance vessel defect, and use miniature skin flap with vessel to repair defect of soft tissue, and expand the area of contact surface of severed fingers to deal with distal section and finger tip without vein. Results 112 fingers were survived among 136 repaired fingers. During 1 to 2 years' follow up, the joint function of 42 fingers was excellent, 50 fingers was good, and 20 fingers bad, respectively. The sensation of 45 fingers restored perfectly, 51 fingers' fairly well recovered, and 16 fingers' poorly restored. 64 fingers had perfect blood circulation, 48 fingers good blood circulation. 62 fingers' appearance was perfect, 34 fingers' appearance was good, and 16 fingers' appearance was bad. Conclusion Flexible operative measures shoud be taken on the basis of special damage to repair vessel defect and severed fingers replanted.