张烽 顾玉东 徐建光 李继峰 200040 上海医科大学附属华山医院手外科 中华手外科杂志 1999 0 15 4


    关键词：运动神经元；细胞死亡；坐骨神经；复方(中药) 期刊 zhswkzz 0 基础研究 fur -->


    

【摘要】 目的 对112例亚急诊足趾移植再造拇手指的功能进行比较，并提出该症亚急诊手术时限的选择和功能评定标准。方法 按伤后不同手术时间，随机抽取112例进行功能随访。评定标准：按再造拇手指活动度、感觉、力量和综合使用能力等四项进行记分，每项4分，16分为满分。结果 伤后48小时以内及3 ～ 5天这两时间段，再造拇手指的功能优良率明显高于伤后6～ 9天、10～14天及15 ～ 20天3组。术后早期进行系统功能康复训练者，功能恢复较不训练者要好。 结论 亚急诊足趾移植再造拇手指的时限，应控制在伤后5天内较好。该功能评定标准在临床应用中证实是实际的、可行的。

Follow - upof the functions of subemergently reconstructed thumb and fingers

SHOU Kuishui, XU Lei,RUI Yongjun, et al. Wuxi Hand Surgery Hospital, Wuxi 214062

【Abstract】 Objective To analyzethe functions of subemergently reconstructed thumb and fingers in 112 cases, and discussthe timing of the operation and the criteria for functional evaluation. Methods 112 cases of subemergently reconstructed thumb and fingers wererandomly chosen from 848 cases of different posttraumatic intervals. The patients werefollowed up and the functions of the reconstructed thumb and fingers were assessedaccording to the following criteria: the movement, sensation, strength and comprehensiveutilization of the reconstructed thumb and fingers. Each item was graded from 1 to 4scores. The higher the score, the better the function. The results of the cases withdifferent posttraumatic intervals were compared. Results The function of the thumb and fingers reconstructed within 48 hoursand 3 ～ 5 days posttraumatically was superior tothat of the digits reconstructed 6 ～ 9 days, 10 ～ 14 days and 15 ～ 20days posttraumatically. The difference was of statistical significance (P < 0.05). Conclusions The optimal time for subemergent reconstruction of thumb andfingers was within 5 days after the injury. The functional evaluation standard waspracticable in clinical practice.

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