闭合性指动脉损伤的诊断与治疗

目的探讨闭合性指动脉损伤采用血管移植修复的可行性。方法通过对2003年6月至2008年5月28例闭合性指动脉损伤病例采用血管移植修复受损的指动脉，总结闭合性指动脉损伤的诊断与治疗。结果本组28例手术后成活27例，成活率96．4％。平均随访12个月，采用国际手外科联合会Nako—mura tamal评价标准，优18例，良8例，中1例，失败1例，优良率为92．8％。结论确诊为闭合性指动脉损伤者，应积极治疗，尽早手术探查，采用血管移植修复损伤的指动脉。对损伤段血管的判断、术中血管移植，以及术后护理十分重要。

Diagnosis and treatment of closed injured arteries by vascular grafting

Objective To explore the feasibility of repairing the closed injured arteries by vascular grafting. Methods Retrospective study was performed to the 28 cases of closed injury of digital arteries that were repaired by vascular grafting from June 2003 to May 2008. Result 27 of the 28 cases survived, and the survival rate was 96.4%. 28 cases were followed up, the average time was 12 months. The evaluation of the results was based on the Nako - mura tamal standard set by International Federational of Societies for Surgery of the Hand （IFSSH）. And the result was excellent in 18 cases, good in 8, eligible in 1, fail in 1. The excellent rate was 92. 8%. Conclusion Patients who were diagnosed as the closed injury of digital arteries should be treated actively, surgical exploration should be performed and the injured arteries should be repaired by vascular grafting as soon as possible. The judge of the segment of injured vessles, the vascular grafting during the operation, and the postoperative care are of great-importance.