指尖离断再植的血运重建

目的 探讨指尖离断再植时血运重建的方式。方法 临床上采用4种血运重建的万式对352例401指尖离断进行再植:①吻合指动脉与静脉的断指再植;②动-静脉转流方式的断指再植;③只吻合指动脉的断指再植;④静脉动脉化的断指再植。结果 352例401指,成活381指,成活率95％,手指外形和长度与健指相似,两点辨别觉2～6mm,指甲生长良好。结论 依据显微镜下清创所见离断指尖动静脉损伤状况,选用不同的血运重建方式,有助于扩大指尖再植适应证,提高再植成功率。

Circulation reconstruction in replantation of amputated fingertip

Objective To investigate the ways of circulation reconstruction in replantation of amputated fingertip. Methods The 352 cases (401 digits) amputated fingertips were replantated with 4 ways of circulation reconstruction: ①replantation with anastomosing digital artery and vein; ②replantation with transferring digital artery-vein; ③Dreplantation only with anastomosing digital artery; ④replantation with using arteriolized digital veins. Results Among the 352 cases(401 digits)who received replantation, 381 fingertips survived with satisfactory appearance, 2-PD of 2-6mm and with fine growth of nails, the survival rate was 95%. Conclusion The ways of blood circulation reconstruction would be chosen according to the injury of artery and vein in amputated fingertip found during debriding under microscope, thus it would enlarge the using range of replantation of fingertips and raise the survival rate of replanted fingertips.