指固有动脉静脉化治疗YamanoⅡ区指撕脱离断的临床应用

Clinical application of proper digital arteriography in the treatment of avulsed finger in Yamano Ⅱ zone

目的 探讨Yamano Ⅱ区指撕脱离断应用指固有动脉静脉化重建静脉回流的临床疗效。方法 选取2015年3月至2020年8月,我科收治的 Yamano Ⅱ区指撕脱离断患者22 例,因断端创面静脉条件差,术中行指固有动脉静脉化建立静脉回流,术后随访观察再植指体外观、甲板生长、感觉恢复情况,采用中华手外科断指再植评分进行评价。结果 再植22指中1指坏死,其余都存活,无静脉危象出现。随访4~12 (7±2.3)个月,术后再植指体外观良好,甲板生长良好,痛、温觉恢复正常,两点辨别度为4.3~6.5(5.2±0.6) mm。结论 应用指固有动脉静脉化治疗 Yamano Ⅱ 区指撕脱离断,临床疗效好、患者满意度高,是恢复 Yamano Ⅱ 区指撕脱离断静脉回流有效的治疗选择。

Objective To investigate the clinical effect of venous return reconstruction by phleboplasty of proper digital artery in the treatment of avulsed finger in Yamano Ⅱ zone.Methods From March 2015 to August 2020,22 patients with avulsed finger in Yamano Ⅱ zone were selected.Venous return reconstruction was applied due to the poor venous condition of the severed wound.General appearance,nail plate growth and sensory recovery were evaluated by the Chinese Hand Surgery Finger Replantation Scale.Results Necrosis was observed in 1 finger.The rest were alive without venous crisis.All patients were followed up for 4-12 months (average:7±2.3 months).Good general appearance,satisfactory nail plate growth and sensory recovery were achieved.The two-point discrimination was 4.3-6.5 mm (5.2±0.6).Conclusions Proper digital arteriography achieves satisfactory clinical outcomes in the treatment of avulsed finger in Yamano Ⅱ zone.