本文選題：再植術(shù) + 側(cè)支��； 參考：《廣州醫(yī)學(xué)院》2012年碩士論文

【摘要】：目的 研究末節(jié)指動(dòng)脈側(cè)支的解剖學(xué)特點(diǎn)，探討吻合單根動(dòng)脈指尖再植的側(cè)支回流的流體力學(xué)機(jī)制。 方法 對(duì)10只新鮮成人尸體手標(biāo)本進(jìn)行乳膠灌注，顯微解剖觀測(cè)手指末節(jié)指動(dòng)脈側(cè)支的數(shù)量、側(cè)支起始處的外徑。對(duì)5支手的指動(dòng)脈鑄型標(biāo)本進(jìn)行觀測(cè)，測(cè)量末節(jié)指動(dòng)脈側(cè)支和主干的角度。用簡(jiǎn)易裝置建立模擬吻合單根動(dòng)脈指尖再植流體力學(xué)模型，觀察理想液體的側(cè)支回流現(xiàn)象。對(duì)85指僅吻合單根動(dòng)脈指尖再植病例進(jìn)行總結(jié)。 結(jié)果 指動(dòng)脈末節(jié)側(cè)支數(shù)為12.7±3.2，側(cè)支外徑為0.32±0.08mm。約60.3%的末節(jié)指動(dòng)脈側(cè)支與主干的角度在30°～60°之間，指動(dòng)脈弓處側(cè)支與主干的角度接近90°。從模擬吻合單根動(dòng)脈指尖再植流體力學(xué)模型上觀察到理想液體的側(cè)支回流現(xiàn)象。臨床上85指指尖再植病例，成活81指，壞死4指，成活率為95.3%。 結(jié)論 指動(dòng)脈吻合口近端有一定數(shù)量的側(cè)支存在，在指尖再植術(shù)中應(yīng)盡量保留指動(dòng)脈吻合口近端側(cè)支，盡量縮短指動(dòng)脈吻合口與側(cè)支的距離。動(dòng)脈側(cè)支回流現(xiàn)象可用流體力學(xué)的伯努利定律（ρgh+ρv2+p=C）分析，這種現(xiàn)象是吻合單根動(dòng)脈指尖再植成活的主要機(jī)制。
[Abstract]:PurposeTo study the anatomical characteristics of the collateral branches of the distal phalanx artery and to explore the hydrodynamic mechanism of collateral reflux from the anastomosed fingertips of a single artery.MethodTen fresh adult cadavers were perfused with latex. The number of the lateral branches of the digital artery and the external diameter at the beginning of the lateral branches were observed by microdissection.To measure the angle of the lateral branch and trunk of the digital artery of the terminal phalanx, the cast specimens of the digital artery of 5 hands were observed.A simple hydrodynamic model was established to simulate the replantation of the fingertip anastomosed with a single artery to observe the phenomenon of collateral reflux of ideal liquid.The replantation of 85 fingers with only one artery tip anastomosed was summarized.ResultThe number of branches at the end of the digital artery was 12.7 鹵3.2, and the external diameter of the lateral branch was 0.32 鹵0.08mm.About 60.3% of the distal phalanx artery had an angle between the lateral branch and the main artery between 30 擄and 60 擄, and the angle between the lateral branch and the main artery at the arch of the digital artery was nearly 90 擄.The phenomenon of collateral reflux of ideal liquid was observed from the hydrodynamic model of simulated anastomosis of the fingertip of a single artery.In 85 finger replantation cases, 81 fingers survived and 4 fingers were necrotic, the survival rate was 95.3%.ConclusionThere are a certain number of lateral branches in the proximal end of the anastomosis of digital artery, so the distance between the anastomosis of digital artery and the lateral branch should be kept as far as possible in the replantation of finger tip.The phenomenon of arterial collateral reflux can be analyzed by the Bernoulli's law of hydrodynamics (蟻 gh 蟻 v 2pc), which is the main mechanism of anastomosis of the finger tip of a single artery.
【學(xué)位授予單位】：廣州醫(yī)學(xué)院
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2012
【分類號(hào)】：R322;R658

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