Clinical Study On The Treatment Of Hand Ischemic Disease With Vascular Adventitia Stripping

Objective: Ischemic diseases of the hand are a group of diseases caused by dysfunction of the circulatory system of the hand.Ischemic diseases of the hand cause the fingers to become painful,cold,numb,and tricolored with pallor,cyanosis,and redness,causing intractable ulcers and even disability due to ischemia and necrosis.Ischemic diseases of the hand are rare with a low clinical incidence.The clinical treatment is inconsistent and the efficacy is inexact.In recent years,many scholars have made a lot of researches on the etiology,diagnosis and treatment of this disease,and concluded that hand ischemic diseases are related to abnormal spasm of sympathetic nerve excitation and abnormal blood vessels in the hand.In this paper,we investigated the clinical efficacy of extravascular membrane peeling in the treatment of hand ischemic diseases by studying the clinical data of patients with hand ischemic diseases in our hospital in recent years.Methods: A total of 10 patients with hand ischemic diseases were admitted to our hospital from 2019 to 2022.All patients complained of cold fingers,which could be accompanied by resting pain,pressure pain,hyperalgesia or hypersensitivity.On examination,abnormal skin color,hypothermia,positive Allen test of the finger arteries,and positive cold water provocation test were observed.The patient’s ultrasound examination suggested the presence of stenosis in the finger artery,and after a clear diagnosis,surgical treatment was performed using nerve block anesthesia.2cm in length.In the case of polydactyly,two 3 cm longitudinal incisions were made at the wrist joint to separate the radial and ulnar arteries,and the outer membrane of the radial and ulnar arteries was stripped 2 cm by microscopic excision of the neurovascular bundles.For patients with symptomatic thumbs,an additional incision was made at the snuff bottle.Postoperatively,a baking lamp was given for warmth as well as vasodilating anticoagulation therapy.Results: All patients were followed up for 3-12 months after surgery,with a mean time of 10.2 months;significant temperature changes were detected with an infrared thermometer on the day of surgery,the skin became red,and the nail color approached normal.The differences in finger temperature and finger pulse oxygen before and after surgery were statistically significant(P<0.01).No progression or exacerbation was observed in any of the postoperative patients.Conclusion: Extravascular membrane peeling surgery in the treatment of hand ischemic diseases.It can effectively block sympathetic nerves,inhibit abnormal spasm of hand arteries,effectively increase blood supply,improve hand ischemic symptoms,promote healing of ischemic ulcers and improve resting pain in the hand,with rapid results,low recurrence probability and high patient satisfaction,which is worthy of clinical promotion.