摘要
目的分析经吻合血管游离腕横纹复合组织瓣桥接创面修复断指再植术的治疗效果。方法抽取焦作市第二人民医院2016年9月至2020年8月收治的断指患者62例,根据手术方案分为观察组和对照组,每组31例。对照组实施常规缩短指骨断指再植术,观察组行吻合血管游离腕横纹+组织瓣桥接创面修复无缩短断指再植术。比较两组血运情况(皮氧分压、氧饱和度、患指微循环检测值、毛细血管充盈时间)、断指成活情况、手指功能及断指运动功能。结果观察组皮氧分压、氧饱和度高于对照组,患指微循环检测值低于对照组,毛细血管充盈时间短于对照组(P<0.05)。观察组断指颜色正常比例(93.55%,29/31)、张力正常比例(83.87%,26/31)及成活率(96.77%,30/31)均高于对照组(67.74%,21/31;58.06%,18/31;74.19%,23/31),P均<0.05。观察组手指功能恢复优良率(90.32%,28/31)高于对照组(64.52%,20/31),P<0.05。观察组断指灵巧度、活动度、肌力等评分均高于对照组(P均<0.05)。结论吻合血管游离腕横纹复合组织瓣桥接创面修复无缩短断指再植术治疗断指患者的效果显著,可改善血运情况,促进手指功能恢复。
Objective To analyze the effect of replantation of severed finger with free neovascular transverse wrist crease combined with tissue flap for wound repair.Methods Sixty-two patients with severed fingers treated in the Second People’s Hospital of Jiaozuo from September 2016 to August 2020 were selected,and they were divided into observation group and control group according to the surgical plans,with 31 cases in each group.The control group received routine shortening of phalanges and replantation of severed fingers,the observation group underwent replantation of severed finger without shortening with free neovascular transverse wrist crease combined with tissue flap for wound repair.The blood supply(skin oxygen partial pressure,oxygen saturation,microcirculation value of the affected finger,capillary blood vessel filling time),survival of severed finger,finger function,motor function of severed finger were compared between the two groups.Results Compared with the control group,the skin oxygen partial pressure and oxygen saturation were higher,the microcirculation value of the affected finger was lower,and the capillary filling time was shorter in the observation group(P<0.05).The proportion of normal color of severed fingers(93.55%,29/31),the proportion of normal tension(83.87%,26/31)and the survival rate(96.77%,30/31)in the observation group were higher than those in the control group(67.74%,21/31;58.06%,18/31;74.19%,23/31),all P<0.05.The excellent and good rate of finger function recovery in the observation group(90.32%,28/31)was higher than that in the control group(64.52%,20/31),P<0.05.The scores of finger dexterity,mobility and muscle strength of the observation group were higher than those of the control group(all P<0.05).Conclusions Replantation of severed finger without shortening with free neovascular transverse wrist crease combined with tissue flap for wound repair is effective in treating severed finger patients,which can improve blood supply,and promote the recovery of finger function.
作者
周鑫
卫阔
倪国骅
张豪
Zhou Xin;Wei Kuo;Ni Guohua;Zhang Hao(Deaprtment of Trauma Microscopic Orthopedics,the Second People’s Hospital of Jiaozuo,Jiaozuo 454001,China;Department of Trauma Orthopedics,NO.988 Hospital of Chinese People’s Liberation Army Joint Logistics Support Force,Jiaozuo 454002,China)
出处
《中国实用医刊》
2022年第5期41-44,共4页
Chinese Journal of Practical Medicine
关键词
断指
无缩短断指再植术
吻合血管游离腕横纹
组织瓣桥接创面修复
Amputated finger
Replantation of severed finger without shortening
Free neovascular transverse wrist crease
Tissue flap for wound repair
