静脉动脉化再植血运恢复延迟现象及意义

发布时间：2018-02-01 02:26

本文关键词： 静脉动脉化断指再植血运恢复延迟　出处：《广东医学》2017年S1期 　论文类型：期刊论文

【摘要】：目的探讨静脉动脉化再植血运恢复延迟现象及意义。方法收集常规无法再植的断指试行静脉动脉化再植19例24指。静脉动脉化再植是将近端的动脉与远端静脉吻合作为供血,吻合1~3根静脉作为回流。骨、肌腱、神经等手术处理同常规再植。记录再植断指的血供恢复时间,即手术完成后松止血带起至断指皮肤颜色变暗红或红色记录为血运恢复时间。结果 24指中除8指放止血带立即变红外,出现血运恢复延迟现象16指,发生率为66.7%。16指术中血供恢复时间:20 min内血运恢复9指;2 h内6指;最长1例术后9 h才逐渐恢复。24指再植均成活。结论高质量的静脉动脉化血管吻合后,断指仍无血液灌注,应考虑到血运延迟现象,认识静脉动脉化再植后的血运恢复延迟现象具有较为重要的临床意义。
[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.
【作者单位】：张家港市第三人民医院手外科;
【分类号】：R658.1
【正文快照】： 静脉动脉化为常规无法再植的断指提供了再植思路,临床应用广泛,已成为常规再植的重要补充[1-6]。临床上我们注意到,常规再植血管吻合后释放止血带,一般很快恢复血运,除非存在血容量不足等全身因素或血管痉挛、栓塞等局部因素,而在静脉动脉化再植,断指远端在血管吻合后释放止血

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