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目的 总结降低手腕部严重高压电烧伤后肢体截肢率 ,并恢复手部分功能。方法 1987年～1999年收治手腕部重度高压电烧伤 44例 5 5个肢体 ,早期充分减张 ,有血运障碍及时行血管重建手术。及时扩创 ,应用胸、腹部或腹股沟部皮瓣形成单蒂、双蒂或联合皮瓣修复创面 ,同时行抗栓、抗凝及抗炎治疗。创面修复后 ,进行手部感觉和运动功能重建 ,采用自体或异体肌腱移植修复肌腱缺损以及肌腱移位恢复手部功能 ;自体神经或胎儿神经移植修复神经缺损。结果 型截肢率为 43.8% ,自体肌腱移植按 TAM标准均达良级 ,异体肌腱移植达可级。腓肠神经移植 7例 ,胎儿神经移植 1例 ,手指感觉恢复好 ,手内在肌功能部分恢复。结论 重建腕部血管通路 ,皮瓣修复创面 ,及时重建运动和感觉功能是减少手腕部重度电烧伤截肢率和恢复手部分功能的有效方法
OBJECTIVE: To reduce the amputation rate of limbs after severe high-voltage electric burn in the wrist and to restore partial function of the hand. Methods A total of 44 cases of severe limbs burned in 55 cases of limbs from 1987 to 1999 were treated with revascularization in early stage. Timely expansion, the application of thoracic, abdominal or groin flap formation of single pedicle, double pedicle or joint flap repair wounds, while antithrombotic, anticoagulant and anti-inflammatory treatment. Wound repair, the hand feeling and motor function reconstruction, the use of autologous or allogeneic tendon graft repair tendon defects and tendon displacement to restore hand function; autologous nerve or fetal nerve graft repair of nerve defects. Result-type amputation rate of 43.8%, autologous tendon transplantation according to TAM standards were up grade, allograft tendon transplantation up to level. Sural nerve graft in 7 cases, fetal nerve transplantation in 1 case, the fingers feel good recovery, part of the internal hand muscle function recovery. Conclusion It is an effective method to reduce the rate of amputation of the wrist and to restore the function of the hand by reconstructing the vascular access of the wrists, repairing the wound with flap, and rebuilding the motor and sensory function in time