Tark K C, Kim Y W, Lee Y H, Lew J D
Department of Plastic Surgery, Severance Hospital, Yonsei University Medical Center, Seoul, Korea.
J Hand Surg Am. 1989 Jan;14(1):17-27. doi: 10.1016/0363-5023(89)90054-3.
During the past 4 years we performed 261 replantations and revascularizations on amputated digits and hands in 153 patients. The overall survival rate was 82%. Clean-cut proximal level amputations and hypothermically preserved amputation parts had the highest survival rate. A higher survival rate and more satisfactory results with accelerated return of sensory function correlated with repair of both digital arteries and two veins rather than only one. All patients experienced intolerance to cold, but this was more troublesome in patients with digital replantation in whom only a single artery was repaired. Digital sensibility and joint motion after replantation were better in these patients who had sharp amputations and on whom repairs were carried out in zone III. Return of intrinsic muscle function after hand replantation was poor; however, patient satisfaction with the procedures remained high.
在过去4年中，我们对153例患者的离断手指和手部进行了261例再植和血管重建手术。总体成活率为82%。整齐的近端离断伤以及经低温保存的离断部分成活率最高。修复指动脉和两条静脉而非仅一条静脉，可获得更高的成活率以及更满意的结果，感觉功能恢复也更快。所有患者均有不耐寒的情况，但在仅修复了一条动脉的手指再植患者中，这种情况更为棘手。在这些锐器离断伤且于Ⅲ区进行修复的患者中，再植后的手指感觉和关节活动情况更佳。手部再植后内在肌功能恢复较差；然而，患者对手术的满意度仍然很高。
