婴幼儿先天性并指畸形的显微外科治疗  

Clinical research of microsurgical treatment of congenital deformity in infants and young children

作　　者：王波 谢冠豪 李军 王永胜 WANG Bo;XIE Guan-hao;LI Jun;WANG Yong-sheng(Department of Trauma and Empyrosis,Central Hospital of Panyu District,Guangzhou,Guangdong,511400,China)

机构地区：[1]广州市番禺区中心医院创伤骨科,511400

出　　处：《中国骨与关节杂志》2018年第12期925-928,共4页Chinese Journal of Bone and Joint

基　　金：广东省自然科学基金(2016A030313755)

摘　　要：目的分析显微镜辅助下和传统放大镜辅助下显微外科手术治疗先天性并指畸形的临床疗效。方法本组124例,且均为我院收治的儿童,受试患儿的纳入时间为2009年3月至2013年7月,均为先天性并指畸形,均行显微外科手术治疗,根据家属意愿,分为放大镜组和显微镜组。比较两组术后疗效和并发症情况。结果在单纯性并指患儿中,采用背侧矩形皮瓣、三角形皮瓣和"M-V"形皮瓣较多,在复杂性并指患儿中,两组均以"M-V"形皮瓣为主;组间皮瓣个数的差异无统计学意义(P>0.05)。术后随访3年,对疗效进行判定,显示两组恢复情况均较好,其中显微镜组优良率为97.18%,明显高于放大镜组81.13%,差异有统计学意义(P<0.05)。术后挛缩屈曲畸形发生率,放大镜组:11.32%,显微镜组:1.41%,差异有统计学意义(P<0.05);关节僵硬发生率,放大镜组:20.75%,显微镜组:1.41%,差异有统计学意义(P<0.05);静脉危象发生率,放大镜组:35.85%,显微镜组:4.23%,差异有统计学意义(P<0.05);局部疼痛发生率,放大镜组:28.30%,显微镜组:5.63%,差异有统计学意义(P<0.05);并发症总发生率,放大镜组:43.40%,显微镜组9.86%,差异有统计学意义(P<0.05)。结论显微镜辅助下手术治疗先天性并指畸形,并发症发生率低,疗效确切与传统手术相比,具有明显优势。Objective To analyze clinical effects of microsurgical treatment of congenital deformity in infants and young children. Methods From March 2009 to July 2013, 124 patients with congenital deformity were collected. All children were divided into 2 groups: traditional surgery group and microsurgery group. Curative effects and complications were compared between the 2 groups. Results In simple deformity patients, dorsal rectangular flap, triangular flap and "M-V" shaped flap were applied; "M-V" flaps were mainly used in both groups; flap number differences were not statistically significant (P>0.05). All patients were followed up for 3 years, and the curative effects were evaluated. All patients recovered well, the excellent and good rate in the microsurgery group was 97.18%, which was higher than 81.13% in the traditional surgery group with statistical significance (P<0.05). The incidence of postoperative contractile flexion deformity: 11.32% in the traditional surgery group and 1.41% in the microsurgery group (P<0.05); the incidence of joint stiffness: 20.75% in the traditional surgery group and 1.41% in the microsurgery group (P<0.05); the incidence of venous crisis: 35.85% in the traditional operation group and 4.23% in the microsurgery group (P<0.05); the incidence of local pain: 28.30% in the traditional surgery group and 5.63% in the microsurgery group (P<0.05); the total incidence of complications: 43.40% in the traditional surgery group and 9.86% in the microsurgery group (P<0.05). Conclusions Microsurgery has obvious advantages in the treatment of congenital deformity, which can improve the curative effects with low complications.

关 键 词：手畸形 先天性 显微外科手术 手术后并发症 矫形外科手术 

分 类 号：R682.1[医药卫生—骨科学]