肘关节深度高压电烧伤的修复  

The Reparation of the Wounded Elbow Joints by Severe High-voltage Electricity Burn and Their Function

作　　者：付晋凤[1] 魏迪南[1] 赵辉[1] 江河[1] 汤勇[1] 马克娴[1] 

机构地区：[1]昆明医学院第二附属医院烧伤科,昆明650101

出　　处：《昆明医学院学报》2001年第3期53-54,共2页Journal of Kunming Medical College

摘　　要：总结深度肘关节高压电烧伤的修复 .6例中采用背阔肌肌皮瓣 3例、胸大肌肌皮瓣 2例及侧胸壁皮肤筋膜瓣 1例修复肘关节创面及重建肘关节功能 .术前行血管造影了解伤肢血管受损情况 ,术前术后辅以高压氧治疗 ,保护间生态组织 ,促进创面愈合 .结果 :6个肢体皮瓣均成活 ,肘关节得以保留 .随访 6～ 12个月 ,2例肘关节功能完全恢复 ,1例部分恢复 ,3例失去随访 .结果表明 :肘关节电烧伤的修复可采取多种皮瓣 .背阔肌肌皮瓣在创面修复和功能重建时应列为首选 ;肘关节屈侧创面或背部烧伤者可选用胸大肌肌皮瓣 ;侧胸壁皮肤筋膜瓣仅适用于少量骨外露和软组织缺损者 .术前造影有助于手术方案的选择 ,高压氧治疗可促进皮瓣成活 .To summarize methods for repairing burn by high-voltage electricity and restoring the function of the wounded elbow joints, transpositioned were 3 latissimus dorsi myocutaneous flaps, 2 pectoralis major myocutaneous flaps and 1 skin-facial flap in lateral pectus among 6 cases. Extremitas superior angiography was performed to detect injured level of blood vessels before operation. As an assistant treatment, hyperbaric oxygen treatment was used before and after operation to help healing. All flaps survived completely. After 6~12 months, the elbow joints and their functions were satisfactorily restored in 2 cases and elbow joints′ function were partly restored in 1 case. No follow-up survey could be found . In conclution, various flaps were available for patients suffering from high-voltage electricity burns when their elbow joints wounds and functions needed repairing and restoring. Latissimus dorsi myocutaneous flap was the top choice. Pectoralis major myocutaneous flap could be used if wounds were in dorsa or flexor of elbow joints. Skin-facial flap in lateral pectus were only suitable for small bone exposure and soft tissues defects. Angiography can help to choose the needed kind of operation. Hyperbraric oxygen treatment can protect tissues from partial vitality and increase survival rate of flaps.

关 键 词：肘关节 电烧伤 肌皮瓣 创面修复 

分 类 号：R647[医药卫生—外科学]