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挤压技术在手指再植术后静脉危象中的实验与临床应用

[Experiment and clinical application of squeezing technique in venous crisis after replantation of finger].

作者信息

Chen H, Zhu Z, Xu G

机构信息

Research Laboratory of Microsurgery, Tai Zhou Hospital, Ze Jiang, P. R. China.

出版信息

Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 1997 Nov;11(6):347-9.

PMID:9868003
Abstract

In search of a new method for treating venous crisis after replantation of the finger, the effect of instantaneous, quick and forceful squeezing on the belly of replanted finger (the so-called SQUEEZINGG TECHNIQUE) was studied. In the animal experiment, 20 SD rats were used. The femoral veins and arteries were separated in order to measure the venous pressure. The result showed that the venous pressure was (8.33 +/- 1.29) x 10(-2) kPa in normal condition, (20.61 +/- 2.34) x 10(-2) kPa in the condition simulating venous crisis and (73.9 +/- 5.74) x 10(-2) kPa on carrying out the squeezing technique. The second part of the experiment was performed on ten human fingers which were amputated because of trauma or other diseases. One of the arteriae digitales palmares propriae and two of its accompanied veins were disected, and all other blood vessels were ligated. The artery was irrigated with normal saline at a pressure of 12 kPa. When both veins were left open, the venous pressure was (1.32 +/- 0.17) kPa; (4.29 +/- 0.49) kPa, when both were ligated; and (16.88 +/- 5.25) kPa when the squeezing technique was applied at the time venous crisis developed. From May 1991 to May 1996, this method was used for 43 times in 25 cases (35 fingers) with venous crisis after replantation. It was successful for 39 times in 21 cases (30 fingers). It was very important that the performer should use the thumb and the index finger to squeeze just the belly of the involved finger, and that every squeeze should be forceful, quick and instantaneous. It was suggested that if this method was properly performed it could improve the survival rate of replanted fingers. The mechanism of squeezing technique in the treatment of venous crisis following replantation of finger was proposed.

摘要

为寻找一种治疗手指再植后静脉危象的新方法,研究了对手指再植部位(即所谓的挤压技术)进行瞬间、快速且有力的挤压所产生的效果。在动物实验中,选用了20只SD大鼠。分离股静脉和动脉以测量静脉压力。结果显示,正常情况下静脉压力为(8.33±1.29)×10⁻²kPa,模拟静脉危象时为(20.61±2.34)×10⁻²kPa,实施挤压技术时为(73.9±5.74)×10⁻²kPa。实验的第二部分在10根因外伤或其他疾病而被截肢的人手指上进行。解剖一根指掌侧固有动脉及其两条伴行静脉,结扎所有其他血管。以12kPa的压力用生理盐水冲洗动脉。当两条静脉均开放时,静脉压力为(1.32±0.17)kPa;两条静脉均结扎时为(4.29±0.49)kPa;在静脉危象发生时应用挤压技术时为(16.88±5.25)kPa。1991年5月至1996年5月,该方法在25例(35指)手指再植后静脉危象患者中使用了43次。21例(30指)成功39次。至关重要的是,实施者应仅用拇指和示指挤压患指的再植部位,且每次挤压都应有力、快速且瞬间完成。建议若正确实施该方法可提高再植手指的成活率。提出了挤压技术治疗手指再植后静脉危象的机制。

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