单侧指动脉结扎治疗无吻合静脉断指成活机理及临床研究

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。

The mechanism and clinical study on the treatment of the severed finger without venous by the unilateral finger artery ligation

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.