摘要
目的介绍足趾移植再造拇、手指术中和术后发生顽固性动脉痉挛的处理方法。方法对19例拇手指缺损的患者,应用游离第二足趾移植再造拇手指术,其中10例在足趾游离后血管断蒂前发生动脉顽固性痉挛,术中仍按常规处理方法进行血管断蒂,拇、手指再造术。9例发生在第二足趾移植再造拇、手指血管吻合通血后至术后83h出现动脉顽固性痉挛而行手术探查,术中将痉挛段动脉切除,取前臂浅静脉作移植。结果术后按显微外科常规方法处理,19例再造拇、手指全部获得成活。结论对拇、手指再造术中和术后出现的顽固性动脉痉挛,采用即时性断蒂或静脉移植桥接动脉的方法是可行、有效的。
Objective To introduce the methods of managing refractory arterial spasm in toe-to-hand transfer. Methods 19 cases of second toe to hand transfer for reconstruction of lost thumbs or fingers were involved in this study. In 10 eases, arterial spasm occurred when dissection of the toe was finished but the vascular pediele was still intact. Despite the refractory vessel spasm, vascular pedicle was divided and the toe harvested for transfer. In 9 cases, arterial spasm occurred immediately after to within 83 hours after vascular anastomosis and reperfusion of the reconstructed digit. The spasmodic artery segment was resected and replaced with vein gTaft. Results All transplanted digits survived. Conclusion Prompt division of the vascular pedicle and replacement of the spasmodic artery with vein graft are effective methods to treat intra-operative or post-operative arterial spasm in toe-to-hand transfer.
出处
《中华手外科杂志》
CSCD
北大核心
2005年第5期280-282,共3页
Chinese Journal of Hand Surgery
