腹部带蒂含真皮下血管网超薄皮瓣在手部损伤修复中的应用价值
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摘要
目的:探讨腹部带蒂含真皮下血管网超薄皮瓣在手部损伤修复中的临床效果。方法:对我院接受手部损伤修复的60例患者随机分为实验组和对照组。对照组采用常规腹部带蒂皮瓣方法修复,实验组采用腹部带蒂含真皮下血管网超薄皮瓣修复,比较两组修复效果。结果:实验组12例感觉功能恢复评分为5分,患者感觉功能恢复良好,6例患者评分为4分,修复总有效率为90%(27/30)高于对照组(83.3%);实验组修复时间为(71.9±12.6)min多于对照组(41.3±10.3)min;实验组修复过程中的出血量为(20.6±5.2)m L、患者修复后住院时间为(2.6±0.4)d,对照组住院时间为(3.5±4)周,实验组住院时间明显优于对照组(P<0.05);修复后实验组有1例患者出现并发症(2.5%)低于对照组(P<0.05)。结论:采用腹部带蒂含真皮下血管网超薄皮瓣在手部损伤修复中效果较好,值得推广应用。
Objective: To discuss the clinical effect of abdominal pedicled subdermal vascular network thin skin- flap in the repair of hand injury. Method: 60 cases of patients received the repair of hand injury in our hospital who were randomly divided into the experimental group and control group. The control group was given routine abdominal pedicled skin flap repair method,the experimental group was given abdominal pedicled subdermal vascular network thin skin- flap in the repair,the repair effect was compared between the two groups. Result: Sensory function recovery score of 12 patients of the experimental group was 5points,sensory function of patients recovered well,a score of 6 patients was four points,the total effective rate of repair was( 90% 27 /30) higher than control group( 83. 3%); The repair time of experimental group( 71. 9±12. 6min) was more than control group( 41. 3 ±10. 3min); The amount of bleeding of the repair process of the experimental group was( 20. 6 ±5. 2m L),the repair time of hospitalization of patients was( 2.6 + 0. 4) days,hospitalization time of the control group was( 3. 5 ±4 week),hospitalization time of the experimental group was significantly better than that of the control group( P <0. 05); There was one case with complications( 2. 5%) after repairing in the experimental group,which was lower than that of the control group( P < 0. 05). Conclusion: Abdominal pedicled subdermal vascular network thin skin- flap has good effect on the repair of hand injury,which is worth promoting and using.
Objective: To discuss the clinical effect of abdominal pedicled subdermal vascular network thin skin- flap in the repair of hand injury. Method: 60 cases of patients received the repair of hand injury in our hospital who were randomly divided into the experimental group and control group. The control group was given routine abdominal pedicled skin flap repair method,the experimental group was given abdominal pedicled subdermal vascular network thin skin- flap in the repair,the repair effect was compared between the two groups. Result: Sensory function recovery score of 12 patients of the experimental group was 5points,sensory function of patients recovered well,a score of 6 patients was four points,the total effective rate of repair was( 90% 27 /30) higher than control group( 83. 3%); The repair time of experimental group( 71. 9±12. 6min) was more than control group( 41. 3 ±10. 3min); The amount of bleeding of the repair process of the experimental group was( 20. 6 ±5. 2m L),the repair time of hospitalization of patients was( 2.6 + 0. 4) days,hospitalization time of the control group was( 3. 5 ±4 week),hospitalization time of the experimental group was significantly better than that of the control group( P <0. 05); There was one case with complications( 2. 5%) after repairing in the experimental group,which was lower than that of the control group( P < 0. 05). Conclusion: Abdominal pedicled subdermal vascular network thin skin- flap has good effect on the repair of hand injury,which is worth promoting and using.
引文
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[2]刘伟,李文芳,付建华,等.真皮下血管网胸三角薄皮瓣鼻再造术6例报告[J].中华医学美容杂志,2007,5(3):165~166.
[3]张高孟,顾玉东,张丽银,等.腹部“S”形皮瓣在手外科应用[J].中华手外科杂志,2012,8(11):26~27.
[4]Lu F,Gao JH,Ogawa R,et al.Preexpanded distant superthin intercostal perforator laps for facial reconstruction without the need for microsurgery[J].Plast Reconstr Aesthet Surg,2006,59(11):1203~1208.
[5]Rashid M,Hussain SS,Aslam R,et al.A comparison of two fascio cutaneous flaps in the reconstruction of defects of the weight-bearing heel[J].Coll Physicians Surg Pak,2003,13:216~218.
[6]马显杰,鲁开化,艾玉峰,等.下腹部多个真皮下血管网皮瓣在手外伤修复中的应用[J].中国美容医学,2009,12(3):61~62.
[7]李佳宇.带真皮血运皮瓣修复手部皮肤缺损46例分析[J].临床和实验医学杂志,2006,5(9):1377.
[8]焦向阳.郭恩谭真皮下血管网皮瓣血供重建的实脸研究[J].中华整形损伤外科杂志,2010,8(3):213~215.
[9]Iida H,Ohashi I,Kishimoto S,et al.Preoperative assessment of anterolateral thigh flap cutaneous perforators by color doppler flowmetry[J].British Journal of Plastic Surgery,2003,56(1):21~25.
[10]彭细峰,刘自飞,徐志军.高压氧治疗对手部皮瓣移植术后疗效的观察[J].中华全科医学,2013,11(10):1530~1531.
[11]郝秋彦,曹相勋,辛军.带蒂真皮下血管网薄皮瓣修复手部创面[J].河北医学,2007,9(3):230~232.