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[手指再植后的感觉恢复]

[Sensory recovery after finger replantation].

作者信息

Eisenschenk A, Lehnert M

机构信息

Orthopädischen Klinik und Poliklinik, Freien Universität Berlin im Oskar-Helene-Heim.

出版信息

Handchir Mikrochir Plast Chir. 1993 Jul;25(4):191-5.

PMID:8375757
Abstract

Criteria for digital replantation is not only revascularization the prerequisite for success, but above all functional recovery of sensibility. In cases of digital replantation, it is necessary to pay special attention to the technical details of nerve repair, for recovery of tactile gnosis. 202 patients with 247 digital amputations were successfully replanted. 138 patients with 172 successfully replanted fingers and 302 digital nerve reconstructions returned for follow-up evaluations. Our aim was to determine the level of sensory recovery depending on the Highet (1954) sensory recovery scheme. Nerve reconstruction was divided into three groups: primary nerve repair, primary nerve grafting, and secondary nerve grafting. 69.4% primary nerve coaptations, 58.3% primary nerve grafting, and 61.9% secondary nerve grafting reached S3 to S4. Most of the replanted fingers regained useful 2PD with S3+. Factors that influenced digital sensibility following replantation including level and mechanism of injury, length of the nerve grafts, cold intolerance, and patient's age are finally discussed in detail.

摘要

断指再植的标准不仅是血管再通作为成功的前提条件,更重要的是感觉功能的恢复。在断指再植病例中,为了恢复触觉识别,必须特别注意神经修复的技术细节。202例患者的247根断指成功再植。138例患者的172根再植手指和302例指神经重建患者接受了随访评估。我们的目的是根据希格特(1954年)的感觉恢复方案确定感觉恢复水平。神经重建分为三组:一期神经修复、一期神经移植和二期神经移植。69.4%的一期神经吻合、58.3%的一期神经移植和61.9%的二期神经移植达到S3至S4。大多数再植手指通过S3+恢复了有用的两点辨别觉。最后详细讨论了影响再植后手指感觉的因素,包括损伤的平面和机制、神经移植的长度、冷不耐受和患者年龄。

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