{"countAll":0,"orderType":null,"readLevel":"0","lyTopicReq":{"id":"1804","isDel":0,"createAt":0,"createBy":null,"createName":null,"updateAt":0,"updateBy":null,"updateName":null,"userId":null,"title":null,"content":null,"barId":"1804","topicTypeId":null,"topicThemeId":"1026","readLevel":0,"files":null,"clickNoLikeCount":0,"clickLikeCount":0,"clickCount":0,"score":0,"partCount":0,"replayCount":0,"publishStatus":0,"publishTime":0,"isCream":null,"canReply":0,"shareUrl":null,"foodCouponVal":0,"emailNotice":0,"permission":0,"zlyShare":0,"status":0,"sort":0,"highlight":0,"highlightEffectTime":0,"digest":0,"digestEffectTime":0,"top":0,"topEffectTime":0,"closed":0,"stamp":0,"icon":0,"bgcolor":null,"fontcolor":null,"favtimes":0,"isAdopt":0,"adoptId":null,"sortDate":0,"metaSearch":null,"rn":null},"lyBarModerators":{"list":[],"list4Map":null,"pageBegin":0,"pageSize":8,"pageNumber":0,"totalPage":0,"totalRow":0},"metaSearch":{"description":"为您提供:宝宝并指多指整形_婴儿六指是什么原因等相关信息，让病友在便捷的求医路上不花一分冤枉钱。","keywords":"宝宝并指多指整形_婴儿六指是什么原因","title":"宝宝并指多指整形_婴儿六指是什么原因","channels":null},"data":{"list":[{"id":"11978","isDel":0,"createAt":1517292003896,"createBy":"8abb11d0af1511e7a3d800163e04584d","createName":"良药苦口","updateAt":0,"updateBy":null,"updateName":null,"userId":"8abb11d0af1511e7a3d800163e04584d","title":"六指怎么形成的 看专家告诉您原因","content":"

 

在我们身边经常会看到，长有六指的儿童，其实，六指是一种儿童较为多见的先天性手部畸形，婴儿一出生就会发现是否有患病，症状明显。六指对于手指的功能和外观都有很大的影响，那么，造成新生儿六指的原因是什么呢？，找良医网告诉您：

\"六指怎么形成的 


1、其实，据医学研究表明，六指是一种染色体的疾病，很多跟遗传是相关的，且有隔代遗传现象。

 

2、环境因素对胚胎发育过程中的影响，如某些药物、病毒性感染外伤、放射性物质的刺激等特别是近代工业的污染都可成为致畸因素肢芽胚基分化早期受损害是导致多指畸形的重要原因。拇指多指畸形即是由于外胚层顶脊的发育异常，拇指侧顶向近位延长及其退缩迟缓所致。

 

找良医网温馨提示：如有身体不适，请及时就医！


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先天性多指、趾畸形是儿童发病率最高的先天性疾病，部分还会伴发心血管或泌尿等其它系统的畸形。多指多见于拇指的外侧和小指的内侧，其他手指较少累及。其中复拇畸形发病率最高，对手部外观及功能影响重大，其诊断和治疗是儿童骨科医生关注的重点。

 

先天性并指亦称蹼指，最常见第3、4指，拇指极少累及。最常见者，相邻两指仅软组织连接，偶尔有骨及关节连接。多见于双侧，有时并发足趾畸形，同时还有其他肢体异常。手在发育过程中，手指开始是并在一起的，再逐步分开形成一个拇指和四个手指。如果在此过程中，出现异常导致手指分开不彻底或没有分开，就会出现部分或完全并指。并指发生的确切原因尚不清楚，少数有遗传性，多数原因不明。

\"专家向您解答先天性并指多指畸形的原因及类型\" 



1.轴前型多指

 

(1)Ⅰ型和Ⅱ型对称型多指：将分叉的中央部分包括拇指的指甲、指骨连同软组织作均等楔形切除，剩余部分并拢缝合;不对称型多指：将偏斜于正常指、发育小的多指切除，但应注意重建指甲的外侧甲沟。

 

(2)Ⅲ型和Ⅳ型对称型多指：采用Ⅰ型和Ⅱ型对称型多指的治疗方法，也可将桡侧或尺侧的多指切除，摆正位置后克氏针内固定，但注意切除桡侧多指应移植拇短展肌，切除尺侧多指应移植拇内收肌，断指再植 畸形矫正 先天畸形不对称型多指：切除多指后做掌骨头楔形切骨，还要注意修复侧副韧带和鱼际肌止点的移植。　　　　

 

(3)Ⅴ型和Ⅵ型：通常切除发育最差的多指(如桡侧的多指，亦可是尺侧的多指)虎口狭窄可行“Z”形延长术，虎口扩大可行紧缩手术。

 

(4)Ⅶ型多指最常见的畸形是拇指分叉，切除多指后楔形切骨或克氏针内固定矫正畸形。

 

轴后型多指：Ⅰ型多指完全切除多指单纯缝合即可，对于Ⅱ型、Ⅲ型多指需确定和保护非常细小的外展肌腱和分叉骨膜外的尺侧副韧带、切除多余指、修整分叉处的多余骨、重建侧副韧带和外展肌腱。中央型多指：单纯的中央型多指应切除发育最差的指，修复、重建的原则同拇指和小指。远端指骨融合的畸形应在1岁内手术，使手的功能能较正常的发育，其余的畸形最好在5岁左右手术。如并指因发育不平衡出现畸形应提前手术，而没有功能的手指则可以在晚些时候施行手术。

 

找良医网温馨提示：如有身体不适，请及时就医！


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\"专家向您解答

   如果夫妻一方或双方有多指并指家族遗传史，其子代由遗传因素作用引起的发病数占总发病数的90.18％，近年来通过进行分子生物学的研究，目前已经定位了4个多指畸形基因位。

 

　　在新生儿中的发生率约为0．30‰—1．90‰。

 

　　每500个小孩就会有1个出现多指症。非洲裔黑人小孩会较多患上轴后多指症，黑人男孩出现轴后多指症差不多是白人的10倍。一项研究发现每1000个白人男性中，就有2.3个患上多指症，而1000个白人女性中，则有0.6个患上；1000个黑人男性中，有13.5个会患有此病，1000个黑人女性中，则有11.1个患上。

 

　　多指症男性高于女性，男女比例为3∶2右手多于左手，比例为2∶1，双手发病约占10%拇指多指发病率约占总数的90%以上。

","barId":"1804","topicTypeId":"1","topicThemeId":"1026","readLevel":0,"files":"","clickNoLikeCount":0,"clickLikeCount":0,"clickCount":1490,"score":0,"partCount":0,"replayCount":0,"publishStatus":1,"publishTime":1510195314623,"isCream":0,"canReply":0,"shareUrl":null,"foodCouponVal":1,"emailNotice":0,"permission":0,"zlyShare":0,"status":0,"sort":0,"highlight":0,"highlightEffectTime":0,"digest":0,"digestEffectTime":0,"top":0,"topEffectTime":0,"closed":0,"stamp":0,"icon":0,"bgcolor":null,"fontcolor":null,"favtimes":0,"isAdopt":0,"adoptId":null,"sortDate":1510195314623,"metaSearch":null,"rn":0,"barTitle":null,"checkcode":null,"forumUser":{"id":"8abb11d0af1511e7a3d800163e04584d","isDel":0,"createAt":1507789271266,"createBy":null,"createName":null,"updateAt":0,"updateBy":null,"updateName":null,"username":"良药苦口","password":"zx13401068656","level":0,"nickName":"周良药","realName":null,"signName":"良药苦口利于病，忠言逆耳利于行！","head":"http://01luntan.com/ly_img/1516263139285.jpg","phone":null,"mobile":null,"wechat":null,"qq":null,"email":"langlixunta@163.com","address":null,"identityType":6,"userType":2,"isPhoneBind":0,"status":0,"accountSource":0,"isStrangerMsg":0,"departmentId":null,"departmentName":null,"sex":1,"provinceId":"110000","cityId":"110114","userLevel":0,"modifyNameCount":1},"lyTopicReply":null,"createAtStr":null,"lyBar":null,"lyTopic":null},{"id":"7214","isDel":0,"createAt":1510194800585,"createBy":"8abb11d0af1511e7a3d800163e04584d","createName":"良药苦口","updateAt":0,"updateBy":null,"updateName":null,"userId":"8abb11d0af1511e7a3d800163e04584d","title":"专家向您解答 多指是怎么引起的","content":"

\"专家向您解答

在目前来看，多指症的病因不是固定的，根据患者个体的不同而不同，非常复杂。导致多指症的原因多为遗传因素，约2/3具有家族遗传病史，且有隔代遗传的家族史。

 

　　多指症是常见的常染色体显性遗传，是最常见的先天性数字异常的手和脚。是先天畸形多种病征的其中一种，或是独有的病征。若是独有的话，很多时都是与单一基因的突变有关，而非多因子性状的突变。不过，不同基因的突变均会引起多指症。

 

　　先天性多指、趾畸形多为单侧性，双侧受累仅占10%左右。复拇畸形确切病因不明，大多为散发，提示该病与环境因素有关，与遗传因素关系不大。例如母亲在怀孕早期4-8周，胚胎肢芽分化时遭受病毒感染，药物，辐射等环境因素的影响，致手指分化障碍而产生畸形。例外的情况是当重复拇指伴发三节拇指时，有些为常染色体显性遗传。

 

　　环境因素也与多指并指也有一定关系，有相当一部分的多指并指是由于环境因素导致，这部分多指并指是开展人群预防的重点。孕期吸烟、孕期接触农用化学物质、孕前职业接触有害物质增加胎儿患多指并指的风险，孕期从事化工职业工作是胎儿多指危险因素。其次，孕母本身的预防保健也十分重要，目前认为母亲年龄过小（14～19岁）而怀孕生产是多指并指的危险因素，妊娠期合并糖尿病将增加胎儿患多指和（或）并指的危险。孕母改善膳食对预防多指和（或）并指有一定作用。膳食中水果类摄入频率较低将增加胎儿患多指的风险，孕早期多吃肉、蛋类将减少胎儿多指并指患病风险。还有研究从卫生经济的宏观角度指出年人均收入高的家庭能减少胎儿患多指并指的风险，有宏观研究报道多指发生率与家庭收入呈负相关，其原因可能也与这些家庭更重视卫生保健有关。

 

　　综上，遗传因素可能是多指或并指先天畸形最主要的发病原因，除此之外，孕前工作环境、孕母年龄、孕早期膳食、环境因素、家庭经济状况与子代多指并指先天性畸形有关。因此，多指并指先天性畸形的预防既要考虑遗传因素，又要考虑环境因素的作用和影响。

","barId":"1804","topicTypeId":"1","topicThemeId":"1026","readLevel":0,"files":"","clickNoLikeCount":0,"clickLikeCount":0,"clickCount":1551,"score":0,"partCount":0,"replayCount":0,"publishStatus":1,"publishTime":1510194800586,"isCream":0,"canReply":0,"shareUrl":null,"foodCouponVal":1,"emailNotice":0,"permission":0,"zlyShare":0,"status":0,"sort":0,"highlight":0,"highlightEffectTime":0,"digest":0,"digestEffectTime":0,"top":0,"topEffectTime":0,"closed":0,"stamp":0,"icon":0,"bgcolor":null,"fontcolor":null,"favtimes":0,"isAdopt":0,"adoptId":null,"sortDate":1510194800586,"metaSearch":null,"rn":0,"barTitle":null,"checkcode":null,"forumUser":{"id":"8abb11d0af1511e7a3d800163e04584d","isDel":0,"createAt":1507789271266,"createBy":null,"createName":null,"updateAt":0,"updateBy":null,"updateName":null,"username":"良药苦口","password":"zx13401068656","level":0,"nickName":"周良药","realName":null,"signName":"良药苦口利于病，忠言逆耳利于行！","head":"http://01luntan.com/ly_img/1516263139285.jpg","phone":null,"mobile":null,"wechat":null,"qq":null,"email":"langlixunta@163.com","address":null,"identityType":6,"userType":2,"isPhoneBind":0,"status":0,"accountSource":0,"isStrangerMsg":0,"departmentId":null,"departmentName":null,"sex":1,"provinceId":"110000","cityId":"110114","userLevel":0,"modifyNameCount":1},"lyTopicReply":null,"createAtStr":null,"lyBar":null,"lyTopic":null},{"id":"7213","isDel":0,"createAt":1510194638218,"createBy":"8abb11d0af1511e7a3d800163e04584d","createName":"良药苦口","updateAt":0,"updateBy":null,"updateName":null,"userId":"8abb11d0af1511e7a3d800163e04584d","title":"为什么有的人会生出多一个手指或脚趾","content":"

 \"为什么有的人会生出多一个手指或脚趾\"

正常情况下，我们每只手或脚都只有5个手指或5个脚趾，那么为什么有的人会生出多一个手指或脚趾呢？当然，对六指或六趾畸形的治疗是不困难的，只要请外科医生将多余的指或趾切除就可以了。

 

   大家都知道，一双手十个手指，每个手指都有它的功用。如果劳动时不慎失去了手指时，外科医生就千方百计地要让它保留下来，因为少去一个手指将会影响工作。

 

   相反，如手上多长一只手指，也会感到碍手碍脚，很不方便，有时还会让别人觉得异样，认为这是“怪胎’，因此在心理上产生自卑感。那么，让我们来看看，是什么原因产生这种畸形的呢?

 

   肢体畸形的种类很多，有两个下肢合并在一起的，医学上称为并腿畸形；有上下肢都不发育的，称无肢畸形；也有手和足都正常，就是没有手臂和腿，手足好象直接长在躯体上，象海豹一样，称短肢畸形等。不过最常见的还是多一个手指或足趾。

 

   畸形的发生与很多因素有关，但主要和遗传以及环境的作用有很重要关系。例如有一个家庭，一家五口人，他们的手和足都没有手指和足趾，如一根木棍一样。有人说这是和近亲结婚有关系。

 

   少指(或趾)的发生原因，有人认为是由于在母亲子宫内的血肿压迫或羊膜粘连而影响了手指或足趾的发育。

 

   多指(或趾)的发生，则有人推测人是从鱼经过几千万年进化而来的，而鱼不是有象桨一样可以游水的“鳍”吗？近头部的一对胸鳍，逐渐演变形成我们的手，在鳍的中间有很多象放射状的鳍刺，每根鳍刺可能变成一个指。

 

   在人类胚胎发生中有时会有这种重演现象，也就是我们老祖宗的形状在胚胎中还保留着，假如因某种因素不发生正常退化，就会出现多指(或趾)畸形。正如我们祖先是有尾巴的，如在胎儿期不发生退化，那么出生后会发生有尾巴的畸形一样。

 

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　　最近，一位8个月男孩患先天性多趾畸形，手指15根，脚趾16根，目前正在接受手术。

\n

　　8个月男孩患多趾症

\n

　　快8个月的男婴圆圆（化名）白白胖胖，天真可爱，与其他婴儿一样。可是，亮出手脚，大家都会惊讶：原来他的手指和脚趾有点多，手指有15根，脚趾有16根，加起来31根，比正常人多出了11根。

\n

　　宁波第六医院院长、手外科主任医师陈宏介绍说，圆圆的情况在医学上叫镜影手、镜影足。这是一种非常罕见的先天肢体畸形，目前在全世界范围内，公开报道的单侧“镜影手”或“镜影足”手术大约做了80例，四肢镜影手、镜影足手术做了大约20例。

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　　目前，圆圆已经在六院做了第一期手术——脚趾矫正。手术挺成功，再过一个星期的观察，拆线后就可回家休养了。

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　　先天性多趾畸形，孩子手指脚趾加起来有31根

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　　手术费用要10万元

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　　圆圆老家在湖南，爸爸妈妈带着他在广东打工。圆圆出生后，爸爸妈妈发现了他的异常：圆圆的手指和脚趾加起来有31根。满月后，爸爸妈妈就带他到湖南省人民医院检查，发现圆圆是得了罕见的镜影手、镜影足，要做手术的话，费用在10万元左右。

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　　圆圆爸爸是一名业务员，收入不高，妈妈因为有了圆圆辞职在家带他，一家子几乎没什么积蓄。“这是我第一个孩子，如果不想办法给他动手术，他长大后一双笨拙的手写不了字，也买不到一双能穿的鞋子，我不希望他这样。”圆圆的爸爸为此网上发帖求助，收效甚微，但也因此引起了媒体的关注。

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　　今年5月份的一天，宁波第六医院手外科副主任医师徐吉海下手术台后拿起手机浏览新闻，无意中看到了有关圆圆的报道。作为一名手外科医生，徐吉海一直在关注跟踪肢体畸形，作为一名父亲，圆圆的遭遇更是激起了他满满的父爱。

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　　他马上通过媒体联系上了圆圆的爸爸妈妈，表示愿意减免医疗费为圆圆做手术。一开始，圆圆的爸爸妈妈并不信任徐吉海，以为他是中介，专门给医院拉病人收取提成。后来，双方加了微信，徐吉海给他们传了身份证和医师执业资格证书。刚好，圆圆家有一个亲戚在舟山打工，爸爸又去向亲戚打听，得知六院是一家正规的公立医院，这才慢慢建立了信任。

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　　世界罕见

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　　四肢镜影手、镜影足

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　　世界公开报道的约20例

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　　作为一名手外科医生，徐吉海见过很多畸形，但当爸爸妈妈亮出圆圆的双手双脚时，他还是忍不住惊讶：圆圆的左手上长出8根手指，右手长出7根手指；两只脚的脚掌上分别生长着8个脚趾，而且都有单独的骨胳。

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　　据六院手外科王欣主任医师介绍，镜影手、镜影足畸形不同于多指畸形。前者是指手的大部分成分的孪生畸形，包括3个以上的手指或掌骨的赘生，其形态如同镜影与手同时存在于一个前臂的远端，成为原位赘生手。赘生手的成分位于手的尺侧，因此又称为尺侧多肢、重复尺骨畸形。镜影手畸形的特征是双尺骨，没有拇指和桡骨结构，表现为一侧七八个手指，胚胎早期肢芽损害可能是导致畸形的原因。

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　　镜影手、镜影足畸形非常罕见。据了解，目前在全世界范围内，公开报道的单侧镜影手或者镜影足大约80例，四肢镜影手、镜影足在20例左右。北京积水潭医院是中国手外科的鼻祖，科室成立50年来，也才做过5例镜影手畸形手术。宁波市第六医院之前做过一例镜影手畸形的手术，圆圆是第二例。

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　　治疗方案

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　　手术分三期进行

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　　已成功完成脚趾矫正

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　　六院手外科团队为圆圆设计了手术方案，共分三期。第一期先做脚趾矫正，已于9月14日完成手术；第二期做手指矫正，预定于圆圆1周岁左右开展；第三期整形，预定于圆圆学龄前完成。

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　　第一期手术在9月14日那天进行。考虑到圆圆还不到8个月，身体承受耐力差，不适合长时间打麻醉，手术时间能短就短，手术就分成两组进行。陈宏、王欣两大主力分别担任主刀医生，率领两组团队，分别为圆圆做左右脚趾的矫正手术。最终，整个手术在1个半小时内完成。

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　　根据手术方案，医生在圆圆的左脚上切了三个脚趾；在右脚上切了4个脚趾，随后拼成一个大脚趾。

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　　“跟普通的多指畸形矫正手术不同，镜影手、镜影足不能随便把多余的手指、脚趾切掉，首先要分清楚哪些手指、脚趾是有功能的，这最考验医生的功夫；其次，即使切掉，也要把其骨骼、关节、肌肉、肌腱、神经、血管、皮肤、指甲等等调整到最佳状态。”王欣说，“孩子还小，以后人生路还很长，要做就要做得尽量完美。”

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　　从目前的情况来看，圆圆的第一期手术挺成功，再过一个星期的住院观察，拆线后就可回家休养了。

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　　等圆圆一周岁，手的功能会更清晰，特别是大拇指，承担了50%的功能，所以必须要搞清楚这么多手指中，哪个或者是哪几个手指有大拇指的功能。这也是把手指矫正手术安排在第二期的理由。做完了脚趾、手指的矫正手术后，会留下疤痕，所以必须安排整形手术。安排在学龄前，也是为了考虑到圆圆的心理，在他上幼儿园之前完成整形手术，有利于他融入集体。

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　　医生呼吁

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　　将肢体畸形治疗费用纳入医保

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　　减轻患者负担

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　　据了解，圆圆这次的医疗费能减免的都减免了，第一期手术，家庭大概承担六七千元。而整个三期手术费用控制在两三万元内，最大程度减轻圆圆家庭的负担。

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　　徐吉海说，圆圆的家庭条件非常一般。“他们从广东到宁波，飞机票600多元，火车票400多元，为了省200元，他们选择坐火车；圆圆做完手术第三天，爸爸就眼泪汪汪地回广东上班去了。”

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　　通过这件事，陈宏也呼吁肢体畸形治疗费用能纳入医保。据他介绍，在宁波光六院一家医院，每年要接诊三四百例肢体畸形病例，其中绝大多数是宁波人。做一例畸形矫正手术，费用高的要三四万元，低的也要近两万元。

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　　“随着人们对美观的要求和对医学的认识，现在的家长往往会比较关注孩子的肢体畸形。条件再不好，也会凑钱给孩子动手术。可是对一些成年人来说，没动手术的基本上都是条件不会太好的，如果有医保，将大大减轻他们的负担。”陈宏说。

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　　据了解，去年，宁波市本地户口孕产妇出生缺陷发生率为17.5‰，出生缺陷发生最多的是先天性心脏病，其次就是肢体畸形。

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