【摘要】 目的　探讨指尖再植的手术要点。方法　对 86指指尖离断进行再植。既吻合指动脉末端分支 ,又吻合指静脉分支 6 8指 ,仅吻合指动脉末端分支 ,不吻合指静脉分支 1 6指 ,动静脉转流 2指 ;神经直接缝合 84指 ,抽出神经束植入指尖皮下 2指。结果　成活 80指 ,成活率为 93%。 6指因术后血管危象坏死而截除。术后随访 6～ 36个月 ,除 8指指甲有增厚卷曲畸形 ,2指指腹有不同程度萎缩外 ,70指外形良好 ,感觉已恢复正常 ,两点辨别觉为 5～8mm。结论　熟悉指尖部动静脉的解剖 ,根据断指的情况 ,选择合适的手术方法和高质量的血管吻合技术 ,是保证指尖再植成功的关键更多还原

【Abstract】 Objective To investige the surgical techniques of fingertip replantation. Methods Severed fingertips were replanted. The vascularization procedures were as follow: both anastomosis of the terminal branches of the digital artery and anastomosis of the branches of the digital vein in68digits, only anastomosis of the branches of the terminal digital artery without repair of the digital veins in 16. Arteriovenous anastomosis in 2, to restore the sensation, the digital nerve was directly sutured in 84 digits, and implanted subcutaneously in 2. The patients were followed up 6 to 36 months portoperativedy. Results 80 replanted fingertips survived, the survival rate being 93%(80/86). 6 digits were removed because of vascular crisis after operation. Satisfactory appearance was obtained in 70 digits,with normal sensation and 2-PD of 5～7?mm. Thickening and coiling of finger nails were seen in 8 digits and atrophy of the fingerpulp in 2. Conclusion Familiarity with vascular anatomy of fingertips, proper methods under different conditions and high quality anastomosis were crucial to the success of fingertip replantation.更多还原