手指多段离断再植的临床研究

目的回顾性分析手指多段离断再植的临床效果。方法对于手指末节、指尖部的断指再植，吻合1条动脉及1条指腹静脉或者吻合1条动脉加拨甲、小切口放血处理，或者行动静脉转流等方法恢复断指血循环；手指中节和近节的离断再植吻合两侧指动脉和2条以上指背静脉，如血管损伤严重，可行浅静脉移植或者邻指动脉移植桥接。结果再植45例81指165段，成活150段，成活率91％。结论手指多段离断再植技术要求高，术中高质量的血管吻合及对血管损伤的有效处理，可以提高断指再植的成活率。加强功能锻炼是再植手指功能恢复的重要环节。

Clinical study on replantation in multiple level amputation of finger

Objective To analyse the clinical outcome of replantation in multiple level amputation of fingers.Methods For fingertip replantation,we anastomosed one artery and one vein,or one artery and pulling out the nail or cutting small incision.For middle and proximal digits replantation, we could anastomose two digital arteries and at least two veins. For severe vascular damage, the superficial vein or arteries from other fingers were used.Results Among 165 segments of 81 fingers from 45 cease,150 segments survived, with 91% survival rate.Conclusion Treatment of multiple level amputation of finger need higher techniques.To improve the survival rate,it is important to anastomose vessel excellently, and deal with damage of vessel correctly. In addition, training exercise plays an important role in functional recovery.