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ID:38141682
大小:791.57 KB
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时间:2019-05-24
《静脉动脉化在手外科领域中的应用》由会员上传分享,免费在线阅读,更多相关内容在行业资料-天天文库。
1、万方数据·734·旦匝处型堂苤查!!!!生!!旦筮兰!鲞笠!!塑!!!!婴生!!!!』!!婴!!!!!!垡!型堕!!!坐!!!!!!!:!!!:垒!:盟!:!!静脉动脉化在手外科领域中的应用江起庭杨丽娜王钰江志伟【摘要】目的探讨静脉动脉化在断指再植、再造及皮瓣移植修复等方面的临床效果。方法手术治疗49例动脉条件特殊的患者,断指再植组2l例,游离移植足趾再造手指组5例,皮瓣组23例,均采用静脉化动脉供血修复手指创面。结果除皮瓣组2例坏死外,其余手指均成活。患者均获随访,时间(4.5±0.6)个月。再植、再造组外观、功能满意;两点分辨觉:再植组为(9.5±0.5)mnl,再造组为(10.5±1
2、.0)mm。皮瓣组外观佳,无明显色素沉着,2一PD为(6.3土0.25)mm。3组病例均按TAM法评定:优42例,良5例,可2例,优良率为95.9%。结论静脉动脉化为手指再植、再造及皮瓣转移在动脉条件特殊、太差、或不牺牲动脉时可提供一种后备之法。【关键词】静脉动脉化;断指再植;组织移植;外科皮瓣;外科手术Veno—arteriolizationinthefieldofhandsurgerysuccessfulex-panslonJIANGQi—ting,YANGLi—na,WANGYu,JIANGZhi—wei.DepartmentofHandSur-gery,ZiChenHandSurg
3、eO"HospitalofChaohu,Anhui238000,China【Abstract】ObjectiveToexploretheclinicaleffectofVeno—arteriolizationindigitreplantationandre—constructionandtransplantationofflap.MethodsAllclinicaldataof49casesofvascularspecialcondi—tionsweredividewhichreceivedsurgicaltreatment,21casesinreplantationgroup,5case
4、sinreconstructiongroup,23casesintransplantationofflapgroup.Allpatientsunderwentveno—arterionlization.ResultsTwocasesnecrosisintransplantationofflapgroup,alltheotherfingerssurviveduneventfully.Thepatientswerefollowedupfor(4.5±0.6)months.Theoutcomewassatistactorybothfunctionallyandcosmeticallyinre—p
5、lantationandreconstructiongroups.2-PDwas(9.5±0.5)mminreplantationgroup,2一PDwas(10.5±1.0)mminreconstructiongroup.Theflapshadexcellentappearance,goodtextureandcolormatchintransplantationofflapgroup.Accordingtothetotalactivemovement(TAM)evaluationsystemintroducedbytheAmericanSocietyforSurgeryoftheHan
6、din1975.theresultsofthisseriesshowedexcellentin42cases,goodin5casesandfairin2cases.theexcellentandgoodratewas95.9%.ConclusionsVeno—arteriol—izationwasanewmethodforhandsurgerytraumainspeciallycircumstances.Owingtoitssimpleprocedure,reliableeffect,itworthtobespreading.【keywords】Veno—arterionlization
7、;Replantationofseveredfinger;Tissuetransplantion;Surgicalflaps;Surgicalprocedures,operative静脉动脉化在手外科中,原来是将末节再植指的指掌侧静脉与指固有动脉吻合[1。3I,将动脉血灌注末节静脉系统中,从而进行物质交换。后来将静脉动脉化延续整个手指再植、全指再造、皮瓣转移,甚至多个全指方面h8I。此法简化了手术步骤,快捷方便,正是DO
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