改良邻指皮瓣与腹部皮瓣对指端皮肤缺损的修复效果
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摘要
目的探讨对指端皮肤缺损患者行改良邻指皮瓣与腹部皮瓣治疗的修复效果。方法将2012年2月~2016年8月廊坊市人民医院收治的166例指端皮肤缺损患者作为研究对象,根据手术方式的不同进行分组研究。经改良邻指皮瓣治疗患者为99例,称为改良组;经腹部皮瓣手术治疗患者为67例,称为腹部组。观察并比较两组患者关节活动能力、住院时间、手术时间、随访评分等各项功能的恢复效果以及围术期临床指标的变化情况。结果改良组治疗优良率、手术时间、住院时间、患者随访评分、关节活动度、外观不满意率、痛觉敏感率、感觉麻木率以及两点辨别实验均优于腹部组(P<0.05)。结论对指端皮肤缺损患者行改良邻指皮瓣治疗,能够改善各项临床指标;与腹部皮瓣治疗方式相比,能够进一步加快患者的恢复速度。
Objective To explore remediation effect of modified cross finger flap and abdominal flap treatment on patients with fingertip skin defect. Methods 166 patients with skin defect who had been treated in Langfang People's Hospita from February 2012 to August 2016 were selected as research objects. They were divided into modified group(99 cases) and abdominal group(67 cases), according to the different surgical methods. The patients in the modified group were treated by modified cross finger flap therapy, and the patients in the abdominal group were treated by abdominal flap surgery. The terms of joint range of motion, length of stay, length of operation, and functional restoration effect in perioperative follow up exanimation in the groups were compared. Results The excellence treatment rate, length of operation, length of stay, follow-up exanimation score, joint range of motion, dissatisfaction degree to repair appearance,pain sensitivity, sensory numbness and two-point discrimination test result in the modified group were superior to those in the abdominal group, with statistically significant difference(P < 0.05). Conclusion Conducting modified cross finger flap for patients with finger tip skin defect can not only improve the clinical indexes, but also accelerate recovery,compared with abdominal flap therapy.
Objective To explore remediation effect of modified cross finger flap and abdominal flap treatment on patients with fingertip skin defect. Methods 166 patients with skin defect who had been treated in Langfang People's Hospita from February 2012 to August 2016 were selected as research objects. They were divided into modified group(99 cases) and abdominal group(67 cases), according to the different surgical methods. The patients in the modified group were treated by modified cross finger flap therapy, and the patients in the abdominal group were treated by abdominal flap surgery. The terms of joint range of motion, length of stay, length of operation, and functional restoration effect in perioperative follow up exanimation in the groups were compared. Results The excellence treatment rate, length of operation, length of stay, follow-up exanimation score, joint range of motion, dissatisfaction degree to repair appearance,pain sensitivity, sensory numbness and two-point discrimination test result in the modified group were superior to those in the abdominal group, with statistically significant difference(P < 0.05). Conclusion Conducting modified cross finger flap for patients with finger tip skin defect can not only improve the clinical indexes, but also accelerate recovery,compared with abdominal flap therapy.
引文
[1]李岩松,邓雪峰,林利忠,等.带指固有神经背侧支的指动脉顺行岛状皮瓣修复指端皮肤缺损效果分析[J].现代医学,2016,44(11):1564-1567.
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[11]周小祥,刘立春,李时军,等.指掌侧固有动脉背侧支皮瓣修复指端软组织缺损35例[J].中华显微外科杂志,2016,39(4):327-330.
[12]白辉凯,谢振军,赵国红,等.示指桡背侧皮神经营养血管皮瓣修复示指指端皮肤软组织缺损[J].中华手外科杂志,2014,30(4):319.
[13]章剑,谢振军,邓小兵,等.游离尺动脉腕上支皮瓣修复手指末节皮肤缺损[J].中华手外科杂志,2016,32(6):478.
[14]张华义.带血管蒂邻指皮瓣修复术治疗手指末节皮肤脱套伤的临床疗效观察[J].实用中西医结合临床,2016,16(6):24-25.
[15]胡盛,覃茂林,邱盛春,等.尺动脉腕上皮支下行支逆行岛状皮瓣的临床应用[J].实用手外科杂志,2016,30(1):110-111.
[16]周晓,薛明宇,许亚军,等.吻合静脉的指背旗帜状皮瓣修复邻指近节皮肤撕脱伤[J].中华手外科杂志,2016,32(5):364-366.
[17]梁高峰,张满盈,吴珂,等.带部分趾神经趾腓侧微型皮瓣修复手指指腹软组织缺损[J].中华手外科杂志,2016,32(6):471-472.
[18]赵风景,张兴群,李宏烨,等.腕横纹桡动脉掌浅支皮瓣修复手指软组织缺损[J].中华整形外科杂志,2016,32(6):468-469.
[19]呼和,丰波,张澜,等.邻指固有动脉顺行岛状皮瓣修复手指中节以远软组织缺损[J].实用手外科杂志,2016,30(3):276-278.
[20]向前,魏辉,高辉,等.邻指皮瓣转位术在指端指腹皮肤缺损治疗中的应用价值探讨[J].中国疗养医学,2016,25(5):499-500.
[2]郑晓东,黄辉强,陈锦涛,等.指掌侧固有动脉背侧支逆行岛状皮瓣修复手指远端皮肤缺损60例[J].中华显微外科杂志,2016,39(4):333-336.
[3]徐少宏,吕少威,叶远坚,等.指固有动脉皮瓣与皮支链皮瓣修复指端皮肤软组织缺损的效果比较[J].中国实用医药,2016,11(15):63-64.
[4]冯仕明,王爱国,张在轶,等.指动脉背侧穿支血管链逆行岛状皮瓣修复指端皮肤缺损[J].中华手外科杂志,2014,30(4):315-316.
[5]李晓亮,谭桂豫,巩凡,等.邻指皮瓣与腹部带蒂皮瓣修复指背皮肤缺损的临床疗效分析[J].宁夏医学杂志,2016,38(08):683-685.
[6]谢冰,陈铁,黄亚峰,等.腹部带血管蒂皮瓣转移修复手外伤皮肤缺损的效果分析[J].中国现代药物应用,2016,10(20):58-59.
[7]秦永平,纪柳,李庆泰,等.邻指皮瓣与腹部皮瓣修复指腹缺损疗效对比分析[J].中国美容医学,2011,20(5):721-722.
[8]刘振忠,蔡原原,刘权文.盐酸川芎嗪在腹部单蒂三叶皮瓣修复多指末端皮肤缺损围手术期中的效果研究[J].河北医药,2013,35(22):3455-3456.
[9]张净宇,马铁鹏,高顺红,等.改良邻指双叶皮瓣修复指掌侧大面积皮肤缺损[J].中国修复重建外科杂志,2015,29(3):395-396.
[10]卢建国,杨庆达,苏瑞鉴,等.手指皮肤缺损显微外科修复的方法及疗效[J].临床骨科杂志,2015,18(5):598-601.
[11]周小祥,刘立春,李时军,等.指掌侧固有动脉背侧支皮瓣修复指端软组织缺损35例[J].中华显微外科杂志,2016,39(4):327-330.
[12]白辉凯,谢振军,赵国红,等.示指桡背侧皮神经营养血管皮瓣修复示指指端皮肤软组织缺损[J].中华手外科杂志,2014,30(4):319.
[13]章剑,谢振军,邓小兵,等.游离尺动脉腕上支皮瓣修复手指末节皮肤缺损[J].中华手外科杂志,2016,32(6):478.
[14]张华义.带血管蒂邻指皮瓣修复术治疗手指末节皮肤脱套伤的临床疗效观察[J].实用中西医结合临床,2016,16(6):24-25.
[15]胡盛,覃茂林,邱盛春,等.尺动脉腕上皮支下行支逆行岛状皮瓣的临床应用[J].实用手外科杂志,2016,30(1):110-111.
[16]周晓,薛明宇,许亚军,等.吻合静脉的指背旗帜状皮瓣修复邻指近节皮肤撕脱伤[J].中华手外科杂志,2016,32(5):364-366.
[17]梁高峰,张满盈,吴珂,等.带部分趾神经趾腓侧微型皮瓣修复手指指腹软组织缺损[J].中华手外科杂志,2016,32(6):471-472.
[18]赵风景,张兴群,李宏烨,等.腕横纹桡动脉掌浅支皮瓣修复手指软组织缺损[J].中华整形外科杂志,2016,32(6):468-469.
[19]呼和,丰波,张澜,等.邻指固有动脉顺行岛状皮瓣修复手指中节以远软组织缺损[J].实用手外科杂志,2016,30(3):276-278.
[20]向前,魏辉,高辉,等.邻指皮瓣转位术在指端指腹皮肤缺损治疗中的应用价值探讨[J].中国疗养医学,2016,25(5):499-500.