静脉动脉化在手外科领域中的应用

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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