摘要【目的】对比分析指尖离断后采用逆行顺序和顺行顺序掌侧静脉吻合再植术的临床疗效，为临床选择最优方式修复指尖离断患者指端功能提供依据。【方法】回顾性分析2010年10月至2013年10月来本院就诊的指尖离断患者80例共216指，按照所行指尖离断再植术方式的不同分为观察组与对照组；观察组进行逆行掌侧静脉吻合再植术，对照组进行顺行掌侧静脉再植术；术后随访1年。比较两组术后效果。【结果】观察组、对照组术后1年指尖成活率分别为91．3％、72．3％，外形良好分别为89指、77指，指甲生长良好分别为89指、77指。观察组两点辨别觉为：（5．1±0．4）mm ，触觉良好者88指，痛觉正常者83指，运动功能良好者77指，对照组两点辨别觉为（6．2±0．6）mm ，触觉良好74指、痛觉正常分别为66指、运动功能良好62指，两组比较均存在明显差异（ P ＜0．05）。【结论】逆行掌侧静脉吻合再植术成活率高、外观与指甲与正常手指相似、术后感觉与运动功能恢复较好，是一种有效的手术方式。
Abstract：Objective To compare clinical efficacy between retrograde and antegrade palm venous anastomosis in the replantation after fingertip amputation so as to provide the basis for choosing best method to recover finger-tip function in patients with fingertip amputation .[Methods] Totally 80 patients with fingertip amputation in our hospital from Oct .2010 to Oct .2013 were analyzed retrospectively .According to the replantation method for fin-gertip amputation ,all patients were divided into observation group and control group .The observation group un-derwent retrograde palm venous anastomosis and replantation ,while the control group underwent antegrade palm venous anastomosis and replantation .All patients were followed up for 1 year .The efficacy after operation was compared between two groups .[Results] The survival rates of fingertips in observation group and control group 1 year after operation were 91 .3% and 72 .3% ,respectively .The number of fingers with good shape in two groups was 89 and 77 fingers ,respectively .The number of fingers with good nail growth in two groups was 89 and 77 fin-gers ,respectively .In the observation group ,the two point discrimination was (5 .1 ± 0 .4)mm ,and the number of fingers with good touch ,normal pain sense and good motor function was 88 ,83 and 77 fingers ,respectively .In the control group ,the two point discrimination was (6 .2 ± 0 .6)mm ,and the number of fingers with good touch , normal pain sense and good motor function was 74 ,66 and 62 fingers ,respectively .There were significant differ-ences between two groups ( P <0 .05) .[Conclusion]Retrograde palm venous anastomosis and reimplantation has advantages such as high survival rate ,good shape and nail similar the normal finger ,good recovery of postopera-tive sense and motor function ,etc .Therefore ,it is an effective surgical procedure .
2014, Vol. 31 
