| 多指离断再植的临床研究 |
| 投稿时间：2010-12-09 修订日期：2010-12-27 点此下载全文 |
| 引用本文：李锦永,王焕新,陈林斌,宋敬忠,孙勇.多指离断再植的临床研究[J].医学研究杂志,2011,40(8):139-141 |
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| 中文摘要:目的探讨多指离断指再植的技术问题及总结临床经验。方法1988年6月~2009年6月， 收治416例915指多断指离断患者。男性313例687指，女性103例228指。年龄最大51岁，最小9岁。断指缺血时间最短4h，最长32h。完全离断787指，不完全离断128指。再植方法：清创-骨固定-修复肌腱-吻合血管-吻接神经。结果成功855指，失败60指，成功率为93.44%。其中断指移位再植38例45指，成功42指，成功率为93.33%。随访（1~4年）79例176指，优95指（5397%），良68指（38.63%），可11指（6.25%），差2指（1.13%），优良率为92.91%。结论多指离断对手功能的影响较大，只要条件许可，均应再植。彻底清创是断指再植成功的前提，精细吻合血管是断指再植成功的关键。 |
| 中文关键词:断指 再植 断指再植 |
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| Clinical Research Issues Related to Multiple Severed Fingers′ Replantation |
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| Abstract:ObjectiveTo explore technical probloms of clinical research on multiple severed fingers replantation and summarize clinical experience.MethodsFrom June 1988 to June 2009,the cases were retrospectively summarized from 915 fingers of 416 multiple severed fingers replantation′s patients.There were 687 fingers of 313 males and 228 fingers of 103 fomales,aged from 9 to 51 years.Broken finger ischemia time was within the shortest period of 4 h,the longest 32 h.There were 787 fingers severed completely and 128 fingers not completely.Replantation method was the following: debridement-fixing the bone-repairing tendon-restoring blood vessels-dialyneury.Results855 fingers have survived and 60 fingers haven′t,and the success ratio was 93.44%.There were 42 fingers survived in 45 fingers shifed and replanted of 38 cases,and the success ratio was 93.33%.176 fingers of 79 cases were followed up from 1 year to 4 years.According to the severed fingers replantation trial function assessment standard of the Chinese Medical Association Society of Hand Surgery,the outcome was excellent in 95 fingers（53.97%）,good in 68 fingers（38.63%），general in 11 fingers（6.25%）and poor in 2 fingers(113%).The excellent and good rate was 92.92%. ConclusionBecause multiple severed fingers have best influence on the hand function,they should be actively replanted as long as patients′ sydtemic condition is so good as to tolerate surgery and replantation can rebuild the function or the partial function.Complete debridement is a prerequisite for successful replantation.Fine vascular anastomosis is the key to successful replantation. |
| keywords:Severed finger Replantation Severd fingers′ replantation |
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