影响断指再植成活率的多因素分析

目的 研究患的年龄、血红蛋白含量、吻合动静脉比例对断指再植成活率的影响。方法 回顾性分析1999年1月一2002年11月844例1231指的断指再植资料，对断指再植成活率与患的年龄、血红蛋白含量、吻合动静脉比例的关系进行统计学分析。结果 年龄因素不影响断指再植的成活率；急血红蛋白含量与断指再植的成活率呈明显正相关；甲根以远平面的断指再植用放血疗法的成活率明显低于吻合1条静脉的成活率；甲根至远侧指间关节平面的断指再植，吻合动脉数多于静脉数时，成活率明显下降；在中节和近节平面吻合动、静脉的比例数不影响成活率，但在近节平面吻合2条动脉的指端血运良好。结论 年龄不应作为筛选断指再植的条件；术后要注意及时纠正贫血；动静脉比例影响断指再植的成活率。

Mutiple factors analysis on survival rate of digital replantation

Objectiv e To study the effects of patient's age,haemoglobin level and artery-to-vein ra tio on survival rate in digital replantation.Methods From January1999to Nov ember2002,we reviewed the replantation of severed finger of844cases(1 231digits).The correlation between survival rate and patient's age,haemogl obin level and artery-to-vein ratio was analyzed.Results Patient's age didn't affect survival rate.There was significant correlation between haemoglobin lev el and survival rate.At the level of nail root to tip,the survival rate of the digits with a vein anastomosed was higher than that of digits treated by method of external bleeding.At the level of nail root to distal interphalange,anasto mosing more arteries than veins led to lower survival rate.At the level of midd le and proximal phalange,the artery-to-vein ratio didn't affect survival rate .But at the level of proximal phalange,anastomosing two arteries led to good b lood circulation of digital end.Conclusion The age should not be regarded as a selected condition of replantation of severed finger.Excessive postoperative an emia should be avoided.Artery-to-vein ratio will affect survival rate of repl antation of severed finger.