吻合手指弓上动脉的微小指尖再植

Replantation of tiny fingertips anastomosed with superior arch artery of finger

目的探讨吻合手指弓上动脉的微小指尖再植的特点及临床疗效。方法自2016年1月至2017年10月对9例12指微小指尖完全离断患者,采用吻合指动脉弓上动脉的方法进行再植,术中均未吻合回流静脉。术后1~3d予低分子肝素静脉推注,并用甲床肝素棉球湿敷的方法改善静脉回流。结果再植9例12指指尖均顺利存活。术后随访8~16个月,再植指尖外形满意,皮色正常,指甲远端甲体生长平整、触觉恢复满意。按中华医学会手外科学会断指再植功能评定试用标准评定:优9指,良3指。结论采用吻合手指弓上动脉的微小指尖再植可获得较高的成活率和满意的疗效。

Objective To explore the characteristics and clinical efficacy of replantation of tiny fingertips anastomosed with superior arch artery of finger.Methods From January 2016 to October 2017,9 patients with complete amputation of 12 tiny fingertips were replanted by anastomosis of the superior digital arch artery,and no reflux vein was anastomosed during the operation.Low molecular weight heparin was injected intravenously 1 to 3 days after operation,and heparin cotton ball wet packing was used to improve venous return.Results Twelve replanted fingertips of 9 cases survived successfully.All the patients were follow-up for 8 to 16 months.The appearance of replanted fingertip was satisfactory,the skin color was normal,the growth of distal nail was smooth,and the tactile recovery was satisfactory.Accordling to the evaluation standard of replantation function of severed fingers of Hand Surgery Society of Chinese Medical Association,9 fingers were excellent and 3 fingers were good.Conclusion The replantation of tiny fingertips with anastomosis of superior digital arch artery can obtain high survival rate and satisfactory clinical efficacy.