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可吸收医用膜在手肌腱损伤一期修复中的应用
作者:程青 刘利波 李军尧 
单位:广州军区武汉总医院急诊科
关键词: 肌腱损伤 可吸收医用膜 缝合技术 功能锻炼 
分类号:
出版年·卷·期(页码):2011·39·第一期(62-64)
摘要:

[摘要] 目的: 观察可吸收医用膜在手肌腱损伤一期修复中的疗效。方法: 本组 126例285条肌腱损伤,其中男性86例,女性40例;平均年龄31.6岁(5~60岁);玻璃割伤42例,刀砍伤44例,电锯伤28例,挤压伤12例;屈肌腱98例182条,其中I区11例12条,Ⅱ区37例63条,Ⅲ区26例47条,Ⅳ区10例26条,V区14例34条,伸肌腱28例103条。合并血管神经损伤72例,合并骨折 55例,均一期采用改良Kessler法缝接肌腱,并用可吸收医用膜包裹,术后早期循序渐进康复锻炼。结果: 本组126例随访,时间3~ 24个月,按TAM法评定疗效,优59例,良52例,可10例,差5例。结论: 修复肌腱损伤应仔细清创,无创操作,良好肌腱吻合技术加可吸收医用膜的应用及早期功能锻炼是肌腱功能恢复的关键。

Abstract Objective: To investigate the therapeutic effects of one-stage repair of hand tendon injuries by DIKFIM. Methods: Among 126 patients with(285 tendons)hand injuries,86 patients were male and 40 patients were female,ranging in age from 5 to 60 years,with an average of 31.6 years.Forty-two patients got injuries by glasses,44 patients got injuries by knife,28 patients got injuries by saw,and 12 patients got crush injuries.The flexor tendon injuries(98 cases 182 tendons) in this study consisted of 11 cases(12 tendons) of I zone, 37 cases (63 tendons) of II zone, 26 cases(47 tendons) of III zone,10 cases(26 tendons) of IV zone and 14 cases(12 tendons) of V zone.The extensor tendon injuries were 98 cases(182 tendons). Seventy-two patients complicated with injuries of blood vesse1 and nerve, and 55 patients also hand fingers fractures.All the patients were treated with modified Kessler method to repair tendon and given DIKFIM at one-stage,and were given early rehabilitation step by step. Results:After the treatment,126 patients were followed up from 3 to 24 months.According to TAM standard,59 patients got an excellent result, 52 good, 10 fair and 5 bad.Conclusion: Microsurgical one-stage tendon repair should be applied.Early rehabilitation, microsurgery repair and DIKFILM are important preventing tendon adhesion.

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