断指再植与非断指再植治疗手指末节完全离断的效果比较

Comparison of the Effects of Severed Finger Replantation and Non-severed Finger Replantation in the Treatment of Complete Severed Fingertips

目的比较断指再植和非断指再植对手指末节完全断离的治疗效果。方法方便选取2017年6月—2019年11月该院收治的50例手指末节完全离断伤的患者为研究对象,随机分成对照组、观察组,每组25例。对照组行非断指再植手术治疗,观察组行断指再植手术,比较两组治疗效果。结果观察组25例(35指),再植成功共22例(30指),再植成功率为85.71%(30/35);观察组患者的远端指间关节活动度(63.11±4.21)°于对照组(45.31±3.83)°,差异有统计学意义(t=18.783,P<0.05);观察组患者的指甲长度(15.61±2.13)mm长于对照组(11.47±2.13)mm,差异有统计学意义(t=8.243,P<0.05);观察组患者的两点辨别觉(4.15±0.33)mm短于对照组(6.91±0.13)mm,差异有统计学意义(t=47.167,P<0.05);观察组治疗优良率92.00%明显高于对照组68.00%,差异有统计学意义(χ^2=4.500,P<0.05)。结论在对手指末节完全离断治疗中,与非断指再植手术疗法相比,断指再植手术,可为患者保留手指原有长度,改善远端指间关节活动度,提升治疗优良率。

Objective To compare the therapeutic effects of severed finger replantation and non-severed finger replantation on complete severance of the distal segment of the finger.Methods A total of 50 patients with complete dissection of the fingertips who were admitted to the hospital from June 2017 to November 2019 were conveniently selected as research objects,and they were randomly divided into a control group and an observation group with 25 cases in each group.The control group underwent non-severed finger replantation surgery,and the observation group underwent severed finger replantation surgery to compare the treatment effects of the two groups.Results There were 25 cases(35 fingers)in the observation group,22 cases(30 fingers)were successfully replanted,and the replantation success rate was 85.71%(30/35);the range of motion of the distal interphalangeal joint of the observation group was(63.11±4.21)°better than the control group(45.31±3.83)°,the difference was statistically significant(t=18.783,P<0.05);the nail length of the observation group was(15.61±2.13)mm longer than the control group(11.47±2.13)mm,the difference was statistically significant(t=8.243,P<0.05);The observation group's two-point discrimination(4.15±0.33)mm was shorter than that of the control group(6.91±0.13)mm,the difference was statistically significant(t=47.167,P<0.05);the treatment excellent rate of observation group was 92.00%,significantly higher than that of the control group,68.00%,with a statistically significant difference(χ^2=4.500,P<0.05).Conclusion In the treatment of complete severance of the distal segment of the finger,compared with non-severed finger replantation surgery,replantation of severed finger can preserve the original length of the patient’s finger,improve the mobility of the distal interphalangeal joint,and increase the excellent rate of treatment.