改良血管套接法与血管端端吻合法对断指再植患者术后功能恢复的对比研究

Comparative study on postoperative functional recovery of the patients received replantation by improved vascular grafting and vascular end-end anastomosis

目的通过对手指离断患者,断指再植术后患指远端血液循环和经皮血氧分压的检测,对比分析断指再植术中常用的两种血管吻合方式即改良血管套接法与传统的血管断端端端吻合法在断指再植术后的治疗效果。方法选择2010年3月—2015年7月笔者所在医院手显微外科住院患者134例共断指208指,将研究对象随机分为2组,即对照组采用传统端端吻合法（73例共断指107指）,观察组采用改良血管套接法（61例共断指101指）,均分别于患者术后第1、2、4、7天检测患指远端血液循环和经皮血氧分压,统计数据应用χ~2检验和t检验进行数据统计分析。结果在断指再植术后第1、2、4、7天,观察组患指远端血液循环和经皮血氧分压均优于对照组,差异有统计学意义（P〈0.05）。结论改良血管套接法与传统血管断端端端吻合法相比,可以明显改善断指再植指术后局部的血液供应,可以明显提高断指再植患指的成活率。

Objective Through the detection of the distant blood circulation and transcutaneous oxygen partial pressure,to compare and analyse two methods commonly used in digital replantation improved vessel sheath connection method and traditional vascular broken end to end to end anastomosis in therapeutic effects for the patients after replantation of amputated finger. Methods From March 2010 to July 2015 in author’s department of microsurgery the 134 patients（totaled amputated 208） were randomly divided into two groups：the control group received the traditional end to end kiss legitimate 73 cases（amputated fingers 107）,the observation group received improved vascular sleeve connection method in 61 cases（amputated fingers 101）,respectively;then,after 1,2,4,7days the distant blood circulation and transcutaneous oxygen partial pressure of all the patients were detected,and obtained data were taken statistical analysis. Results After replantation of severed fingers at 1,2,4 and 7 days,the observation group in distant blood circulation and transcutaneous oxygen partial pressure was superior to the control group,and the difference is statistically significant（P〈0.05）. Conclusion Improved vessel sheath connected method and the traditional vascular broken end end end anastomosis can all significantly improve postoperative local blood supply,the survival rate of ampatated fingers,but the former is more significant than the latter.