吻合一条血管的指端组织块再植体会

目的评估吻合一条血管的指端组织块再植的临床疗效。方法2005年7月-2008年12月住院的38例（38指）指尖组织块离断患者，采用仅吻合一条管径最粗血管进行原位再植。结果38例指尖离断组织块，除1例因发生静脉危象部分坏死，经换药处理后瘢痕愈合，余均成活。术后随访3个月-2年，再植成活复合组织块颜色红润，指腹指纹清晰，感觉恢复S3-S4级，外形满意，无萎缩，接近正常手指。按中华医学会手外科学会拇、手指功能评定试用标准评定．优28指．良10指。结论手指离断复合组织块应积极再植，通过缝合指固有动脉或其分支，缝合静脉或静脉动脉化．增加再植成活率。

The experience of replanting tissue blocks from fingertip by anastomosising a blood vessel

Objective To evaluate the clinical efficacy of replanting tissue blocks from fingerfp by anastomosising a blood vessel. Methods From July 2005 to December 2008, a total of 38 patients with fingertip tissue block mutilation were treated in situ replantation by anastomosising the largest blood vessel. Results 1 case of partial necrosis occurred due to the venous crisis, but cured after dressing change, 38 cases of fingertip tissue blocks survived. All patients were followed up for 3 to 24 months, the survived replanted tissue blocks had the advantages of plump, a clear fingerprint, a sensory recovery about $3~$4 level, a satisfactory appearance without atrophy and closed to the normal finger. Results were evaluated by using the criteria for function of reconstruced thumb and fingers issued by the Hand Surgery Society of the Chinese Medical Association, 28 cases were excellent, 10 good. Conclusion In order to increase the survival rate of replantation, the tissue blocks from amputated fingertip should be actively replanted by anastomosising digital artery or its branches, anastomosising veins, the arterialization of veins.