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find Keyword "断指再植" 16 results
  • 改良显微缝线吻合血管在断指再植中的临床应用

    目的 总结改良显微缝线吻合血管在断指再植术中的优点及临床效果,为吻合微小血管提供一种新的显微缝线。 方法 2004 年4 月- 2008 年4 月,应用改良显微缝线及传统显微缝线于157 例202 指断指再植术中吻合微小血管。男137 例,女20 例;年龄16 ~ 47 岁。机器压伤102 指,机器割伤39 指,电锯锯伤39 指,其他伤22 指。离断指别:拇指27 指,示指63 指,中指56 指,环指30 指,小指26 指。完全离断162 指,不完全离断40 指。受伤至手术时间30 ~ 200 min。随机分两组,改良组78 例105 指,应用改良显微缝线吻合血管342 条;传统组79 例97 指,应用传统显微缝线吻合血管325 条。 结果 单针吻合时间改良组(20.0 ± 2.5)s,传统组(28.0 ± 3.5)s;每一吻合口吻合时间改良组(12.5 ± 2.5)min,传统组(18.5 ± 4.3)min;吻合血管后至完全再通时间改良组(10.0 ± 2.6)min,传统组(12.0 ± 3.5)min;术后改良组出现血管危象致血管栓塞5 指(4.76%),传统组10 指(10.30%)。术后两组再植指体成活率改良组95.23%,传统组89.69%。末节再植成活率改良组95.34%,传统组89.47%;非末节再植成活率改良组95.16%,传统组89.83%。两组各指标比较差异均有统计学意义(P lt; 0.05)。患者均获随访,随访时间3 个月~ 2 年,再植指外观、功能恢复均满意。 结 论 应用改良显微缝线吻合微小血管具操作简便、可靠、缩短血管吻合时间及血管再通时间、提高断指再植术成功率等优点。

    Release date:2016-09-01 09:05 Export PDF Favorites Scan
  • THE FLOW CYTOMETRIC ANALYSIS OF ACTIVATED PLATELETS OF SEVERED FINGER BY SEVERE INJURY BEFORE AND AFTER REPLANTATION

    To investigate the significance of activated platelet levels before and after surgical operation in patients with severed finger by severe injury, the P-selectin (CD62p) positive platelet percent in peripheral blood was studied in 32 patients before and after operation by flow cytometric immunology. At the second and third day after operation, seventeen patients, which in a high positive platelet percent, were measured again after anticoagulation treatment with a large dose of urokinase etc. The results were that the levels of CD62p positive platelet in peripheral blood before and after operation were significantly higher than that of the normal group (P lt; 0.01). The CD62p positive platelet percent was increased not much more in the anti-coagulation patients than in the normal ones (P gt; 0.05). There were a few vascular crisis observed. This study suggested that severed fingers by a crushing or wringing injury enhance the platelet activity and resulted in hypercoagulation, thus anti-coagulation measures should be taken to avoid possible thrombosis and improve the survival rate of replantation. CD62p was one of the sensitive indices of activated platelet, which could be used in calculating hypercoagulation accurately.

    Release date:2016-09-01 11:07 Export PDF Favorites Scan
  • CLINICAL STUDY OF PHALANGE FRACTURES TREATED BY ABSORBABLE INTRAMEDULLARY NAIL IN REPLANTATION OF SEVERED FINGER

    Objective To study the effect of internal fixation with absorbable intramedullary nail on the treatment of phalange fractures in replantation of severed finger. Methods From September 2001 to October 2003, 28 cases with industrial severed finger (21 males and 7 females, with the age of 18-35 years) were replanted within 1-6 hours. The severed locations were index fingers in 11 cases, middle fingers in 8 cases, ring fingers in 6 cases, little fingers in 3 cases. All cases of phalange fractures were fixed by absorbable intramedullary nails of poly-DL-lactic acid(PDLLA) that combined with chitosan. Out of the 28 cases, 15 cases were with proximal phalange, 11 cases were with middle phalange, 2 cases were with distal phalange. The bone marrow cavity of the phalanges were dilated, then the intramedullary nail was inserted with suitable diameter and length to fix the fracture. Postoperatively resin bandage was applied for 3-4 weeks.Results All the 28 patients survived the performance and postoperative follow-up ranged from 3 to 10 months(4 months in average). Rejection was observed in one case 3 weeks after operation, bone unions were obtained in other cases. According to the Chinese Medical Association’s evaluation standard for replantation of amputated finger, 18 fingers resulted in excellence, 9 fingers in good function and 1 with unsatisfactory function. The excellent and good rate was 96.4%. Conclusion Internal fixation with absorbable intramedullary nail of PDLLA combined with chitosan proves to be effective in the replantation of severed finger.

    Release date:2016-09-01 09:29 Export PDF Favorites Scan
  • 36例47指末节离断再植

    Release date:2016-09-01 09:28 Export PDF Favorites Scan
  • COMPREHENSIVE REHABILITATION IN THE TREATMENT OF FUNCTIONAL IMPAIRMENT AFTER REPLANTATION OF MULTIPLE FIN GERS INJURY

    The comprehensive rehabilitative treatment was used in 58 cases(194 finger)for functional impairment after eplantation. After the treatment the overall increase of flexion-extension range of motion was 30 to 130 degrees respectively. From the assessment of 10 items of daily activities, the patients could accomplish three-fourth of them. the average time taken for the treatment was 3 months with an excellent-good rate about 87.4%. Through the early comprehensive rehabilititive treatment patients could achieve better results.

    Release date:2016-09-01 11:34 Export PDF Favorites Scan
  • Research on the Influence of Three Postoperative Analgesia Methods on the Survival Rate of Replanted Finger by Flat Digital Subtraction Angiography

    ObjectiveTo observe the influence of three postoperative analgesia methods on the survival rate of replanted finger by flat digital subtraction angiography (DSA) medical imaging detection system. MethodFrom July 2014 to July 2015, 342 patients were classified into gradeⅠ and gradeⅡ replantation in accordance with their physical condition and they were randomly divided into routine oral group, muscle injection group and analgesia group with 144 patients in each. Flat DSA was used to dynamically observe replantation after revascularization. Then we compared the three different analgesia methods in terms of psychological status of the patients, incidence of vascular crisis, occlusion rate, survival rate of replanted fingers. The function score of replanted fingers was evaluated for clinical efficacy. ResultsCompared with the conventional oral group and muscle injection group, the incidence of vascular crisis in replanted fingers and thrombosis rate were significantly lower in the analgesia group which had a replanted finger survival rate of 96.69% and a normal mental condition rate of 78.07%. Six months after surgery, the rate of excellent and good follow-up was significantly higher than the conventional oral group and muscle injection group (P<0.017) . ConclusionsThe 3-D technology of flat DSA can provide clear and reliable pictures of vessel revascularization status for replanted fingers. The use of continuous brachial plexus analgesia performs better than other methods of analgesia. Good analgesia can stabilize patients' anxiety and negative emotions, which is helpful to avoid excessive fluctuations in blood pressure induced by small artery spasm caused by blood clots and vascular crisis, thereby increasing the survival rate of replanted fingers and facilitating early rehabilitation of their function.

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  • CLINICAL APPLICATION OF DIVERSION OF ARTERY-VEIN FLOW IN VASCULAR ANASTOMOSIS

    The method of diversion of the arteryvein flow was used for vascular anastomosis in 12 cases undergoing replantation of the severed limbs(fingers)and free tissue transplantations. The results from this method were successful. The efficacy of this method of re-establishment of the blood circulation broadened the indications for replantation and also provided a method of choice in cases when there was impediment of the venous return during tissue transplantation.

    Release date:2016-09-01 11:33 Export PDF Favorites Scan
  • 吻合掌侧静脉且保留指甲的多指指尖离断再植

    目的总结采用吻合掌侧静脉且保留指甲方法再植治疗多指指尖离断的疗效。 方法2006年10月-2011年12月,对8例17指指尖离断采用吻合掌侧静脉且保留指甲的方法进行再植。男5例,女3例;年龄11~45岁,平均26岁。致伤原因:冲压伤4例,电锯伤2例,切割伤2例。受伤指别:示、中、环指1例,示、中指4例,中、环指3例。受伤至手术时间2~6 h,平均3 h。 结果术后再植指全部成活,切口均Ⅰ期愈合。8例均获随访,随访时间7~24个月,平均16个月。患指外形及长度与健指相似,指甲平整,关节活动良好。触觉、温痛觉均恢复,两点辨别觉4~7 mm。末次随访时,根据中华医学会手外科学会断指再植功能评定标准评定:获优14指、良3指,优良率达100%。 结论多指指尖离断采用吻合掌侧静脉及保留指甲方法再植,不仅能提高断指成活率,还可恢复手指良好外观及功能。

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  • 游离静脉皮瓣在复杂性断指再植中的应用

    目的 总结游离静脉皮瓣在复杂性断指再植中的应用。 方法2008年1月-2011年12月,在59例(59指)断指再植术中采用腕掌侧静脉皮瓣游离移植修复缺损。男46例,女13例;年龄17~56岁,平均29.6岁。致伤原因:冲压伤31例,压砸伤17例,爆炸伤11例。受伤至入院时间30 min~3 h 30 min,平均95 min。损伤指别:拇指11例,示指17例,中指12例,环指9例,小指10例。皮肤软组织缺损范围1.5 cm × 1.5 cm~ 5.0 cm × 3.0 cm。皮瓣切取范围2 cm × 2 cm~5 cm × 3 cm。供区创面直接拉拢缝合。 结果术后第7天2例皮瓣边缘表皮坏死,1例再植手指坏死。51例获随访,随访时间12~18个月,平均15.5个月。皮瓣外观、质地良好,皮瓣及手指浅痛觉及触觉恢复,两点辨别觉为5.0~8.5 mm,平均7.4 mm。术后12个月,根据中华医学会手外科学会上肢部分功能评定试用标准评定,获优38例,良11例,差2例,优良率为96.1%。 结论在合并血管缺损的复杂性断指再植中应用游离静脉皮瓣,可同时修复血管缺损及创面,扩大了断指再植适应证,疗效满意。

    Release date:2016-08-31 04:21 Export PDF Favorites Scan
  • APPLICATION OF VENOUS Flow-through FLAP IN FINGER REPLANTATION WITH CIRCULARITY SOFT TISSUE DEFECT

    ObjectiveTo investigate the treatment outcome of applying venous Flow-through flap in the replantation of severed finger with circularity soft tissue defect and vascular defect. MethodsBetween January 2010 and December 2012,11 cases (11 fingers) of severed finger with circularity soft tissue defect and vascular defect underwent replantation with venous Flow-through flaps.There were 8 males and 3 females,aged 18-42 years (mean,24.6 years).The cause of injury was squeeze injury in 6 cases,crush injury in 3 cases,and strangulation in 2 cases.Combined injuries included nerve defect in 3 cases (1.0,2.0,and 3.5 cm in length),and tendon defect in 2 cases (2.0 and 6.5 cm in length); cyclic skin and soft tissue defect was 3.0-4.5 cm in width,was 1/2-1 finger circumference in length,and was 2.0 cm×1.0 cm to 7.0 cm×4.5 cm in size.Six cases had complete circular defect (both finger artery and vein defects),and 5 cases had incomplete circular defect (only finger artery defect),and vascular defect was 1.0-4.5 cm in length.The time from injury to operation was 1.5-4.5 hours. ResultsVenous crisis occurred in 1 case at 2 days after operation,was cured after vein graft; flap edge necrosis was observed in 2 cases and was cured after dressing change and skin grafting respectively; flap edema and blister occurred in 2 cases and relieved spontaneously.The other 6 flaps and replanted fingers survived completely,with primary healing of incision.Ten cases were followed up 12-18 months (mean,15.5 months).Only a linear scar was seen at the donor sites,with no functional limitation.The flaps had similar color and texture to adjacent skin.The two-point discrimination was 6.5-13.0 mm (mean,8.6 mm).According to replanted finger function scoring system of Society of Hand Surgery of Chinese Medical Association,the results were excellent in 6 cases,good in 3 cases,and poor in 1 case at last follow-up,and the excellent and good rate was 90%. ConclusionVenous Flow-through flap can repair both vascular defect and soft tissue defect,so it has good outcome in increasing the survival rate of replanted finger for severed finger replantation with circularity soft tissue defect and vascular defect.

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