CAJ | 학술논문

目的：评估吻合一条血管的指端组织块再植的临床疗效。方法2005年7月-2008年12月住院的38例（38指）指尖组织块离断患者，采用仅吻合一条管径最粗血管进行原位再植。结果38例指尖离断组织块，除1例因发生静脉危象部分坏死，经换药处理后瘢痕愈合，余均成活。术后随访3个月～2年，再植成活复合组织块颜色红润，指腹指纹清晰，感觉恢复S3～S4级，外形满意，无萎缩，接近正常手指。按中华医学会手外科学会拇、手指功能评定试用标准评定，优28指，良10指。结论手指离断复合组织块应积极再植，通过缝合指固有动脉或其分支，缝合静脉或静脉动脉化，增加再植成活率。
목적：평고문합일조혈관적지단조직괴재식적림상료효。방법2005년7월-2008년12월주원적38례（38지）지첨조직괴리단환자，채용부문합일조관경최조혈관진행원위재식。결과38례지첨리단조직괴，제1례인발생정맥위상부분배사，경환약처리후반흔유합，여균성활。술후수방3개월～2년，재식성활복합조직괴안색홍윤，지복지문청석，감각회복S3～S4급，외형만의，무위축，접근정상수지。안중화의학회수외과학회무、수지공능평정시용표준평정，우28지，량10지。결론수지리단복합조직괴응적겁재식，통과봉합지고유동맥혹기분지，봉합정맥혹정맥동맥화，증가재식성활솔。
Objective To evaluate the clinical efficacy of replanting tissue blocks from fingertip by anastomosising a blood vessel. Methods From July 2005 to December 2008, a total of 38 patients with fingertip tissue block mutilation were treated in situ replantation by anastomosising the largest blood vessel. Results 1 case of partial necrosis occurred due to the venous crisis, but cured after dressing change, 38 cases of fingertip tissue blocks survived. All patients were followed up for 3 to 24 months, the survived replanted tissue blocks had the advantages of plump, a clear fingerprint, a sensory recovery about S3~S4 level, a satisfactory appearance without atrophy and closed to the normal finger. Results were evaluated by using the criteria for function of reconstruced thumb and fingers issued by the Hand Surgery Society of the Chinese Medical Association, 28 cases were excellent, 10 good. Conclusion In order to increase the survival rate of replantation, the tissue blocks from amputated fingertip should be actively replanted by anastomosising digital artery or its branches, anastomosising veins, the arterialization of veins.