CAJ | 학술논문

目的：探讨单侧指动脉结扎治疗无吻合静脉断指再植的临床疗效。方法对56例64指末节、指尖离断患者，在吻合两侧指动脉的基础上，分两组即结扎单侧指动脉组及不结扎单侧指动脉组进行断指再植，并观察两组治疗效果。结果再植56例64指，不结扎单侧指动脉组16例18指，成活11例12指，成活率66.7%；结扎单侧指动脉组40例46指，其中结扎一侧近端优势指动脉再植20例22指，成活18例19指，成活率86.4%，结扎一侧近端非优势指动脉再植20例24指，成活17例20指，成活率83.3%。术后随访6～24个月，成活手指长度与健侧指大致相同，指甲生长良好，手指端皮肤红润，除有3例指腹稍萎缩外余指腹饱满，痛温觉恢复，两点分辨觉可达3～6 mm，功能和外形恢复均较满意。结论采用结扎单侧指动脉治疗无吻合静脉断指能显著提高再植成活率，在临床上安全、有效，是治疗无吻合静脉断指再植一种较好的方法。
목적：탐토단측지동맥결찰치료무문합정맥단지재식적림상료효。방법대56례64지말절、지첨리단환자，재문합량측지동맥적기출상，분량조즉결찰단측지동맥조급불결찰단측지동맥조진행단지재식，병관찰량조치료효과。결과재식56례64지，불결찰단측지동맥조16례18지，성활11례12지，성활솔66.7%；결찰단측지동맥조40례46지，기중결찰일측근단우세지동맥재식20례22지，성활18례19지，성활솔86.4%，결찰일측근단비우세지동맥재식20례24지，성활17례20지，성활솔83.3%。술후수방6～24개월，성활수지장도여건측지대치상동，지갑생장량호，수지단피부홍윤，제유3례지복초위축외여지복포만，통온각회복，량점분변각가체3～6 mm，공능화외형회복균교만의。결론채용결찰단측지동맥치료무문합정맥단지능현저제고재식성활솔，재림상상안전、유효，시치료무문합정맥단지재식일충교호적방법。
Objective To investigate the clinical effect of by using the unilateral finger artery ligation to treat the severed finger without venous. Methods For the distal fingers without venous anastomosis, based on the anastomosis of both sides of finger artery, and one side of proximal finger artery ligation, comparing the clinical effect with the without ligation and one side of proximal finger artery. Results 56 cases of the 64 finger replantation, 11 cases were succeeded (12 fingers)in the group of without ligation (16 cases of 18 fingers), 18 cases were succeeded (19 fingers) in the group of dominant side proximal finger artery ligation (20 cases of 22 fingers), the survival rate was 86.4%. 17 cases were succeeded (20 fingers) in the group of none dominant side proximal finger artery ligation (20 cases of 24 fingers), the survival rate was 83.3%. Patients were followed up for 6~24 months, the length of survival fingers were roughly the same as the normal fingers, the tip of the finger nail growth was good, skin was ruddy. The pulp were shrunken in 3 cases, others were full, pain and temperature sensation was recovered, two point discrimination was 3~ 6mm, the patients were satisfied with the function and appearance. Conclusion The treatment of the unilateral finger artery ligation of the severed finger without venous is effective and reliable treatment of the replantation of severed finger without venous anastomosis.