【摘要】 目的 探讨上肢局部严重损伤显微外科急诊修复重建临床疗效。方法 2009年5月-2016年8月,对11例上肢局部严重损伤应用显微技术急诊修复重建。采用不同皮瓣移植及时修复闭合创面。有肢体主干血管损伤同时给予Flow_through皮瓣蒂部血管血流桥接,恢复肢体血运。术后常规“三抗”处理。随访测评肢体的外形、感觉、血运、功能和供区恢复情况等,对住院时间、治疗成本、肢体功能临床资料进行综合分析。结果 11例肢体均顺利成活,治愈出院。平均住院时间23.6d。随访时间5~38个月,平均18.3个月,所有肢体外形恢复良好,感觉、血运恢复满意,运动功能根据神经损伤不同获得相应恢复。皮瓣外观好,恢复保护性感觉。皮瓣供区恢复情况满意。结论 对肢体局部严重损伤应把握显微外科修复重建时机,采用急诊Ⅰ期修复,治疗周期短、成本低、功能恢复好,临床疗效满意。对肢体严重损伤修复水平提高有更加积极意义。更多还原

【Abstract】 Objective To investigate the methods and treatment outcome for repairment or reconstruction of destructive injury of the upper limb. Methods From May 2009 to Mar 2017, 11 cases with destructive injury of the upper limb were treated with the microsurgery skill. Repair of tissue defect by different flap transfer. If the trunk vascular of upper limb was injuried, pedicle blood vessels of Flow-through flap would bridging the blood flow. Routine use of anti-infective, antispasmodic(vasodilator), anticoagulant postoperation. Following-up and evaluation of the shape of the limbs, feeling, blood supply, function and recovery for the situation. The clinical data of hospitalization time, treatment cost and limb function were analyzed comprehensively. Results All of 11 cases survived uneventfully. The average hospitalization time was 23.6 days. Follow-up time ranged from 5 to 28 months, 18.3 months in average. The shape of all limbs, feeling and blood recovery was well restored. The motor function was restored according to the different nerve injury. The donated site of the flap was well restored. Conclusion For patients with destructive injury of the upper limb,emergency repair is important. Treatment cycle was short,low cost,and functional recovery is good, clinical efficacy is satisfactory. To improve the restoration of destructive injury of limb, emergency repair was more positive.更多还原