目的 探讨动静脉转流术结合拔甲在小儿Ishikawa II区断指再植中的疗效。 方法 2013年7月至2018年11月对27例29指幼儿Ishikawa II区断指进行再植，断指远端均无静脉吻合条件，手术均采用动静脉转流术结合拔甲来解决静脉回流问题，术中行血管移植修复静脉9例、修复动脉5例。 结果 术后29指均存活，其中6例出现回流障碍，经侧切口挑治后成活。所有患儿获随访，随访时间5~18月，平均10.2个月。末次随访均指尖外形尚可，指腹饱满，指甲生长近平整。其中2例指体轻度萎缩。 结论 应用动静脉转流术结合拔甲治疗无静脉吻合条件的幼儿Ishikawa II区手指离断伤能提高再植成活率，临床疗效良好，值得推广。
Abstract
Objective To explore the effect of arteriovenous bypass combined with nail extraction on replantation of amputated finger in Ishikawa II area of children. Methods From July 2013 to November 2018, 27 children with 29 severed fingers in Ishikawa II area without venous anastomosis conditions were replanted by arteriovenous bypass and nail extraction. Venous transplantation for venous repair was performed in 9 cases and arterial repair in 5 cases. Results All of 29 fingers were survived, but 6 fingers had venous drainage problem which survived through lateral incision. All cases were followed up for 5~18 months (average 10.2 months). The shape of fingertips was acceptable, the pulps were full, and the nails grew nearly flat in the last follow-up. Two of them had mild finger atrophy. Conclusions The combination of arteriovenous bypass and nail extraction has good clinical effect in the treatment of amputated finger in Ishikawa II area of children without venous anastomosis conditions, which is worthy of clinical promotion.
关键词
断指 /
静脉回流 /
再植术 /
指损伤
Key words
Amputated finger; Venous reflux; Replantation /
Finger injury
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