断指再植与非断指再植治疗手指末节完全离断伤的临床效果和安全性

Clinical effect and safety of severed finger replantation and non-severed finger replantation in the treatment of complete amputation of distal finger

目的探讨断指再植与非断指再植治疗手指末节完全离断伤的临床效果和安全性。方法选取100例手指末节完全离断伤患者,根据治疗方案分为观察组和对照组,各50例。对照组患者予以非断指再植治疗,观察组患者予以断指再植治疗。比较两组患者的断指成活情况、并发症发生情况、感觉恢复情况、手功能恢复情况。结果观察组患者断指完全成活率明显高于对照组(70.00%vs.34.00%),并发症发生率明显低于对照组(8.00%vs.26.00%)(P<0.05)。术后6个月、12个月,观察组患者的单丝触觉、两点辩觉明显优于对照组(P<0.05);术后12个月,观察组患者浅痛觉存在率高于对照组(76.00%vs.46.00%),O'Rain温水浸泡起泡试验阳性率低于对照组(14.00%vs.36.00%),运动功能、日常活动、感觉恢复、血液循环状态、外观、工作恢复情况评分均高于对照组(均P<0.05)。结论在手指末节完全离断伤治疗中,相较于非断指再植,实施断指再植治疗可进一步提升断指成活率,促进感觉恢复,改善手功能,并发症发生率低。

Objective To investigate the clinical effect and safety of severed finger replantation and non-severed finger replantation in the treatment of complete amputation of distal finger.Methods A total of 100 patients with complete amputation of distal finger were selected and divided into observervation group and control group according to treatment plan,with 50 cases in each group.The control group was treated with non-severed finger replantation,and the observation group was treated with severed finger replantation.The survival of severed finger,occurrence of complications,recovery of sensation and hand function were compared between the two groups.Results Compared with the control group,the observation group had higher complete survival rate of severed finger(70.00%vs.34.00%)and lower incidence of complications(8.00%vs.26.00%)(P<0.05).At 6 months and 12 months after operation,the monofilament tactile sensation and two-point discrimination of the observation group were better than those of the control group(P<0.05).Twelve months after operation,the presence rate of shallow pain in the observation group was higher than that in the control group(76.00%vs.46.00%),and the positive rate of blister test in O'Rain warm water was lower than that in the control group(14.00%vs.36.00%),the scores of motor function,daily activities,sensory recovery,blood circulation status,appearance and work recovery were higher than those in the control group(all P<0.05).Conclusion Compared with non-severed finger replantation,replantation of severed finger can further improve the survival rate of severed finger,promote sensory recovery and improve hand function,with low incidence of complications in the treatment of complete amputation of distal finger.