吻合手指掌侧静脉在手指末节再植中的临床效果分析

Clinical effect analysis of palmar venous anastomosis in fingertip replantation

目的探讨在手指末节再植中吻合手指掌侧静脉的可行性及临床效果。方法2008年10月至2017年5月,采用门诊、电话和微信的方式回顾性分析15例24指末节再植患者的临床资料。离断手指均吻合一组动脉重建动脉血供,吻合手指掌侧静脉建立静脉回流,指神经根据损伤情况随机缝合。结果术后随访18~65(平均39.9)个月,除1例旋转撕脱离断的患者出现再植手指坏死外,余下14例23指均完全成活。术后静态两点辨别觉为3.6(2.8~4.0)mm,术后手指屈、伸功能良好。本组患者对治疗效果均满意。结论吻合手指掌侧静脉的末节再植可以提高再植手指的成活率,同时简化术后护理,减少术后并发症,提高治疗效果。

Objective To investigate the feasibility and clinical effect of palmar venous anastomosis in fingertip replantation.Methods From October,2008 to May,2017,the clinical data of 15 patients with 24 finger replantation were retrospectively analyzed by outpatient,telephone and WeChat followed-up.One artery was anastomosed for revascularization with or without nerve repair,and 1 palmar venous anastomosis was performed to reestablish the outflow system.The finger nerve was sutured randomly according to the injury.Results The patients were followed-up for 18-65(mean,39.9)months.Except for 1 replantation finger with rotation avulsed injury failed,the remaining 14 cases with 23 fingers survived completely.Excellent restoration of finger motion was observed during the follow-up.The mean regained static 2-point discrimination sensation was 3.6(2.8-4.0)mm.All patients were satisfied with the treatment effect.Conclusion Successful palmar venous anastomosis can improve the survival rate of replanted fingertips,simplify postoperative care,reduce postoperative complications,and improve the treatment effect.