掌侧动脉静脉化和背侧静脉吻合在末节断指再植中的疗效对比

Comparison of the Effects Between Palmar Arterio-venolization and Dorsal Venous Anastomosis in the Replantation of Severed Distal Segment of Fingers

目的:探究掌侧动脉静脉化和背侧静脉吻合再植对末节断指再植患者手指功能、术后并发症及外观满意度的影响。方法:研究主体为2019年1月-2022年10月于笔者医院接受断指再植手术的患者,将符合纳入排除标准的患者按照随机数字表法分为观察组与对照组,其中对照组50例(54指)患者给予背侧静脉吻合再植术,观察组53例患者(56指)给予掌侧动脉静脉化,统计比较两组围手术期相关指标、再植指功能、生活质量评分、并发症发生情况及患者满意度。结果:观察组住院时间及创口愈合时间均短于对照组(P<0.05),且再植成功率高于对照组(P<0.05),但两组手术时间及术中出血量比较差异无统计学意义(P>0.05);观察组手指功能恢复情况及生活质量评分均优于对照组(P<0.05);随访结果显示观察组并发症发生率低于对照组,且外观满意度高于对照组(P<0.05)。结论:掌侧动脉静脉化和背侧静脉吻合再植在末节断指再植患者中均有确切效果,但前者对促进手指功能及生活质量的恢复更具优势,且术后并发症发生率低,患者满意度也较高。

Objective To investigate the effects of palmar arterio-venolization and dorsal venous anastomosis onfinger function,postoperative complications and satisfaction with appearance in patients undergoing replantation of severed distal segment offingers.Methods The subjects of the study were patients who underwent replantation of severedfingers in author's hospital from January 2019 to October 2022.The patients who met the inclusion and exclusion criteria were divided into observation group and control group according to the random number table method.The perioperative indicators,replantedfinger function,quality of life score,complications and patient satisfaction were compared between the two groups.Results Hospital stay and wound healing time of the observation group were shorter than those of the control group(P<0.05),and the success rate of replantation was higher than that in the control group(P<0.05).There was no statistically significant difference in operation time or intraoperative blood loss between groups(P>0.05).Finger function recovery and life quality score scores in the observation group were significantly better than those in the control group(P<0.05).Follow-up results showed that the incidence of complications in the observation group was lower than that in the control group,and satisfaction with appearance was higher than that in the control group(P<0.05).Conclusion Palmar arterio-venolization and dorsal venous anastomosis both are effective for patients undergoing replantation of severed distal segment of fingers.However,the former has more advantages in promoting finger function recovery and improving quality of life.In addition,the incidence of postoperative complications is lower,and patients'satisfaction is higher.