本文關鍵詞： 靜脈動脈化 斷指再植 血運恢復延遲　出處：《廣東醫(yī)學》2017年S1期 　論文類型：期刊論文

【摘要】：目的探討靜脈動脈化再植血運恢復延遲現象及意義。方法收集常規(guī)無法再植的斷指試行靜脈動脈化再植19例24指。靜脈動脈化再植是將近端的動脈與遠端靜脈吻合作為供血,吻合1~3根靜脈作為回流。骨、肌腱、神經等手術處理同常規(guī)再植。記錄再植斷指的血供恢復時間,即手術完成后松止血帶起至斷指皮膚顏色變暗紅或紅色記錄為血運恢復時間。結果 24指中除8指放止血帶立即變紅外,出現血運恢復延遲現象16指,發(fā)生率為66.7%。16指術中血供恢復時間:20 min內血運恢復9指;2 h內6指;最長1例術后9 h才逐漸恢復。24指再植均成活。結論高質量的靜脈動脈化血管吻合后,斷指仍無血液灌注,應考慮到血運延遲現象,認識靜脈動脈化再植后的血運恢復延遲現象具有較為重要的臨床意義。
[Abstract]:Objective to investigate the phenomenon and significance of delayed restoration of venous arterialization replantation. Methods A total of 19 patients (24 fingers) with venous arterialization replantation were studied. Venous arterialization replantation is a near end artery and distal statics. Vein anastomosis as a blood supply. Anastomosis of 1 to 3 veins was performed as reflux. Bone, tendon and nerve were treated with conventional replantation. Blood supply recovery time of replanted finger was recorded. That is, after the operation, the tourniquet was changed from the loose tourniquet to the dark red or red of the skin of the amputated finger, which was recorded as the recovery time of blood circulation. Results in 24 fingers, except 8 fingers, the tourniquet changed to infrared immediately, and the delayed recovery of blood circulation appeared in 16 fingers. The rate of recovery of blood supply was 66.7%. 16 fingers. 9 fingers recovered within 20 min of blood supply recovery time. 6 fingers within 2 h; The replantation of .24 fingers survived 9 hours after operation. Conclusion after high quality venous arterialized vascular anastomosis, there is still no blood perfusion in the severed fingers, and the phenomenon of delayed blood supply should be taken into account. It is of great clinical significance to understand the delayed recovery of blood supply after venous arterialization replantation.
【作者單位】： 張家港市第三人民醫(yī)院手外科;
【分類號】：R658.1
【正文快照】： 靜脈動脈化為常規(guī)無法再植的斷指提供了再植思路,臨床應用廣泛,已成為常規(guī)再植的重要補充[1-6]。臨床上我們注意到,常規(guī)再植血管吻合后釋放止血帶,一般很快恢復血運,除非存在血容量不足等全身因素或血管痙攣、栓塞等局部因素,而在靜脈動脈化再植,斷指遠端在血管吻合后釋放止血

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