银屑病断肢(指)再植的血管病理观察及临床疗效

目的:观察银屑病患者中小动脉的病理变化;评估银屑病患者断肢(指)再植的临床效果。方法:取中小动脉切片行HE染色并观察,采用内、外固定固定肢体离断部分,通过增加吻合静脉数使得吻合静动脉数比例大于传统比例2∶1,并且调整抗银屑病治疗方案。结果:银屑病中小血管中膜增厚,纤维化明显;7例银屑病患者断肢(指)全部成活,其中1例患者术后3 d出现血管危象,给予扩管、抗凝、改善微循环治疗后缓解。结论:通过增加吻合静脉血管数量,增加静脉回流,并调整抗银屑病治疗方案使得银屑病患者断肢(指)获得良好的效果。

Pathological Observation of Arteries and Clinical Outcomes in Psoriasis Patients with Limb (Finger) Replantation

Objective: To observe the pathological changes in small-and medium-sized arteries of psoriasis patients,and to evaluate the clinical effect of limb or finger replantation in psoriasis patients.Methods: Small-and medium-sized artery sections were observed with HE staining,the amputated limbs were replanted with internal and external fixations,and more veins were anastomosed to increase the vein/artery rate to more than 2∶1,the conventional rate,and adjusted psoriasis treatment at the same time.Results: In psoriasis patients,medium membrane was thickened and fibrosis was shown in small-and medium-sized blood vessels.All the replanted limbs or fingers survived,and only one case occurred postoperative vessel thrombosis and treated by changing dressing and neurocutaneous island flap transplantation.Conclusion: It can get an ideal clinical outcomes of replantation in psoriasis patients by anastomosing more veins to improve venous return and adjusting the treatment of psoriasis at the same time.