长时间热缺血手指末节完全离断断指再植20例
20 cases of replantation of severed terminal phalanx after long time heat ischemia
袁虹豪 1刘承伟 1弓贺炜1
作者信息
- 1. 北京积水潭医院贵州医院手外科,贵州贵阳 550014
- 折叠
摘要
目的 探索对长时间热缺血手指末节完全离断伤行断指再植的临床疗效.方法 2018年5月-2020年12月,对20例共26指热缺血时间超过6h的手指末节完全离断伤行急诊断指再植术,断指热缺血时间为6～15 h,平均为9.1 h.结果 术后20例26指,断指成活15例20指.术后48 h内11例12指出现血管危象,其中4例4指经挑拨、抗血管痉挛对症处理后断指成活;2例2指经急诊手术探查解除血管痉挛后断指成活;5例6指术后缺血坏死.再植成功15例20指术后获得6～12个月随访,再植指外观满意,指甲生长良好,远侧指尖关节活动良好,再植指指腹部两点辨别觉9～12 mm.结论 对于热缺血时间超过6h的手指末节完全离断伤,根据断指条件可予试行断指再植术,手术仍有较高成功率及满意手指功能.
Abstract
Objective To explore the clinical effect of replantation of severed terminal finger after long time heat ischemia.Methods From May 2018 to December 2020,a total of 26 fingers with heat ischemia time of more than 6 hours were treated with emergency finger replantation.The heat ischemia time of fingers was 6-15 hours,with an average of 9.1 hours.Results In our 20 cases of 26 fingers,15 cases of 20 fingers survived.Within 48 hours after operation,11 patients showed vascular crisis.In 4 cases,a total of 4 fingers were alive after picking and antivasospasm symptomatic treatment.In 2 cases,a total of 2 fingers were alive after vasospasm was removed through emergency surgical exploration.Ischemic necrosis occured after replantation of 6 severed fingers in 5 cases.In this group,a total of 20 patients with successful replantation were followed up for 6 to 12 months.The appearance of the replanted finger was satisfactory,the fingernail grew well,the distal fingertip joint moved well,and the two-point discrimination was 9-12 mm.Conclusion For the complete amputation of the end of the finger for more than 6 hours of heat ischemia,replantation of the finger can be tried according to the conditions of the amputation.The operation still has a higher success rate and satisfactory finger function.
关键词
末节/热缺血时间/断指再植Key words
Last section/Heat ischemia time/Replantation of severed finger引用本文复制引用
出版年
2024
NETL
NSTL
万方数据