吻合单条指动脉的末节断指再植

Distal digital replantation by a single common digital artery anastomosis

目的探讨仅吻合单条指动脉的再植方法在末节断指再植中的疗效。方法自2010年3月至2017年4月,对21例22指末节离断伤患者采用吻合1条指动脉吻合方法再植。其中16指末节未采用甲床或侧切口放血;6指末节采用甲床肝素棉球湿敷。术后常规给予抗凝、扩血管药物治疗。结果所有患者获随访13~84个月,平均21.6个月,22指再植指体全部成活,且饱满。其中13指修复指神经,指端两点辨别觉为5~6mm;9指未行神经吻合,术后指端两点辨别觉为7~8mm。结论在末节断指再植中,采用吻合单条指动脉的方法简便可行,术后再植指的外观及功能较满意,是一种治疗末节离断伤较理想的手术方法。

Objective To explore the clinical efficacy of single common digital artery anastomosis in the distal digital replantation.Methods FromMarch 2010 to April 2017,21 patients with 22 distal digital amputations were replanted by a single common digital artery anastomosis.Bleeding through nail bed or lateral incision was not performed in 16 distal digitals;heparin sodium hydropathic compress of the nail bed was given to 6 distal digitals.Routine anticoagulation and vasodilatation therapy were administrated after operation.Results All patients were followed up from 13 to 84 months with an average of 21.6 months.All replanted digitals were survived.Nerves were repaired in 13 digitals,and the two-point discrimination(2-PD)was from 5 to 6 mm.Nerve anastomosis was not performed in 9 digitals,and the 2-PD was from 7 to 8 mm.Conclusion It is a simple and feasible method to use a single common digital artery anastomosis for distal digital replantation.The appearance and function of the replanted digitals are satisfactory.It is an ideal method for the treatment of distal digital amputations.