摘要
目的探讨指背静脉移植在血管缺损的断指再植术中的应用效果。方法收集2021年4月至2022年8月于秦皇岛市第一医院进行断指再植术的35例手指离断患者(40指)的临床资料,术中均采用指背静脉移植桥接术。观察术中镜下挫伤血管内膜挫伤分布情况,记录血管移植的时间。比较同水平面指背静脉与缺损血管的管径,观察术后再植手指的成活情况、并发症发生情况和成活手指的功能恢复情况。结果术后手指成活率为95.0%(38/40)。自切取静脉至完成两处吻合口的时间一般约为40分钟,吻合质量良好。同水平面指背静脉与缺损血管的管径相当或略粗。术后6个月,在成活的38个再植手指中,手指功能优10指,良25指,差3指,优良率为92.1%(35/38)。结论在血管缺损的断指再植术中,指背静脉移植可在避免再植时过多缩短指骨、关节融合或截指的情况下获得满意的外形和优良的功能。
Objective To explore the application effect of dorsal digital vein transplantation in the replantation of amputated fingers with vascular defects.Method The clinical data of 35 patients(40 fingers)with amputated fingers who underwent replantation of amputated fingers at the First Hospital of Qinhuangdao from April 2021 to August 2022 were collected.All affected fingers were underwent dorsal digital vein transplantation and bridging surgery.The distribution of intimal contusions of the contused blood vessels under the microscope during the surgery was observed and the time of vascular transplantation was recorded.The diameter of the dorsal digital vein and the defect blood vessels in the same horizontal plane were compared.The survival of finger replantation,the occurrence of complications and the recovery of survival finger function after surgery were also observed.Result The finger survival rate after surgery was 95.0%(38/40).The time from self-cutting the vein to completing the two anastomosis sites is generally about 40 minutes,and the anastomosis quality is good.At the same level,the diameter of the dorsal digital vein is equivalent to or slightly thicker than that of the defect blood vessels.After 6 months of surgery,among the 38 surviving replanted fingers,10 fingers had excellent finger function,25 fingers were good,and 3 fingers were poor,with excellent and good rate of 92.1%(35/38).Conclusion In replantation of amputated fingers with vascular defects,dorsal digital vein transplantation can achieve satisfactory appearance and excellent function without the need for excessive shortening of finger bones,joint fusion,or finger amputation during replantation.
作者
于晋辉
田宇
张士伟
Yu Jinhui;Tian Yu;Zhang Shiwei(Department of Hand-foot Surgery,First Hospital of Qinhuangdao,Qinhuangdao 066000,Hebei,China)
出处
《血管与腔内血管外科杂志》
2024年第1期93-97,共5页
Journal of Vascular and Endovascular Surgery
基金
秦皇岛市科学技术研究与发展计划项目(202101A056)
河北省重点研发计划项目(20377708D)。
关键词
指背静脉移植
断指再植术
血管缺损
dorsal vein transplantation
replantation of amputated finger
vascular defect