静脉动脉化在手指再植与再造中的应用

目的探讨静脉动脉化再植与再造修复手指创伤的方法。方法对手指斜行离断伤、复合组织块离断伤、套脱伤，离断的部分不含动脉或动脉血管纤细无法吻合，或技术因素经多次动脉吻合失败，无法再吻合时，采用静脉动脉化再植，共7例8指。在切取拇甲瓣或第二足趾再造拇、手指时，由于血管变异无法携带可吻合的动脉进行移植、移植术中多次吻合动脉失败或术后发生动脉广泛栓塞，无动脉可再吻合时，改用静脉动脉化修复血管，共2例。结果9例全部成活。术后随访6个月．3年，功能恢复：优5例，良3例，可1例，优良率达89％。结论静脉动脉化手指再植与再造，对无法行动脉吻合的手指及复合组织离断伤，是一种可行的治疗方法。对游离足趾或足趾复合组织移植再造手指术，若动脉系统出现问题，该方法是挽救指体的一种补救措施。

Application of veno-arteriolization in digit replantation and reconstruction

Objective To discuss the application of veno-arteriolization in digit replantation and reconstruction. Methods 8 fingers in 7 cases underwent veno-arteriolization in digit replantation due to oblique amputation of the fingers, composie tissue loss, degloving injuries, which were short of arteries or the arteries were too small to anastomose, or the arteries were no longer fit for anastomosis after several failure. Veno-arteriolization was employed in second toe to thumb transplantation in 2 cases for vascular variation when no artery could be used. Results All 9 cases were successful. Postoperative follow-up ranged from 6 months to 3 years. Functional recovery was graded excellent in 5 cases, good in 3 cases, and fair in 1 case. The excellent and good rate was 89% . Conclusion Venoarteriolization is a feasible way to replantation of amputated fingers and composite tissue amputation, when arterial anastomosis is impossible. It is also a remedial measure for toe to finger transplantation when there are arterial system problems.