多发伤患者的断肢(指)再植(附23例报告)

目的 探讨合并多发伤伤员断肢(指)再植的适应证、特点及临床效果。方法在1994年7月～2001年6月期间，对23例多发伤伤员损伤严重度评分(ISS)≥16分者，在多科协作积极救治多发伤的同时，先清创离断肢(指)体，并低温保存，待病情稳定后一期行断肢(指)再植术，术后早期进行系统的功能康复练习。结果22例再植成活，随访1～7年，根据断肢断指再植功能评定标准评定：优7例、良13例、差2例，优良率90．9％。结论多科合作、早期救治多发伤、娴熟的显微操作技术是提高多发伤断肢(指)再植成功率的关键。加强早期系统功能练习是再植肢(指)体功能恢复的重要环节。

Replantation of severed limb (finger) with multiple injuries (with 23 case reports)

Objective:To investigate the indication, characteristics and effect of clinical treatment in replantation of severed limb (finger) with severe multiple injuries. Methods:Severe multiple injuries patients with ISS evaluation more than 16 points were chosen for this study. One- stage replantations of severed limb (finger) were performed in 23 patients while their multiple injuries were actively treated. Patients performed functional recovery exercise early after surgery. Results: Among the 23 cases, 22 cases survived. 1 ～7 years follow- up showed that the results were excellent in 7, good in 13, and poor in 2, with an excellent or good rate of 90.9 percent. Conclusions:Multiple specialties cooperation, early treatment of multiple injuries and experienced microsurgery operation are the keys to improve success rate of replantation of severed limb (finger) with multiple injuries. Enhanced early systematic functional exercise is also important in recovering the function of severed limb(finger).