腓肠神经营养血管皮瓣延迟转移术的临床研究  

Clinical study of delayed-transposition of sural neurovascular flap

作　　者：闫飞虎[1,2] 卞承玲[3] 辛磊[4] 韩冬 吴永发[6] 马兵[7] 唐洪泰[7] 贲道锋[7] 

机构地区：[1]第二军医大学附属长海医院肛肠外科 [2]解放军第四一三医院普外科 [3]第二军医大学附属长海医院五官科 [4]第二军医大学附属长海医院消化内科 [5]69234部队卫生队 [6]第二军医大学附属长征医院血管外科 [7]第二军医大学附属长海医院烧伤科

出　　处：《中华损伤与修复杂志（电子版）》2014年第3期49-52,共4页Chinese Journal of Injury Repair and Wound Healing(Electronic Edition)

基　　金：第二军医大学大学生创新基金项目(MS2009053)

摘　　要：目的探讨皮瓣延迟转移对腓肠神经营养血管皮瓣术后愈合的影响。方法将2009年1月至2012年3月就诊于第二军医大学附属长海医院烧伤外科的40例患者随机分为对照组20例和实验组20例,对照组采用传统腓肠神经营养血管皮瓣转移术;实验组采用腓肠神经营养血管皮瓣延迟转移术。术后患者进行愈合评分,评定标准包括术后皮瓣肿胀消退时间、愈合时间、水疱出现情况、皮瓣皮缘发黑情况、是否需要再次手术。比较两组患者术后愈合评定情况。结果实验组术后皮瓣肿胀消退时间(3.19±0.38)d、愈合时间(13.34±0.21)d分别少于对照组(5.54±0.35)d、(15.49±0.42)d,差异有统计学意义(t=-20.355、-20.637,P=0.001、0.001);实验组水疱发生率0(0/20)、再次手术发生率0(0/20)分别低于对照组30.0%(6/20)、30.0%(6/20),差异有统计学意义(χ2=4.902、4.902,P=0.027、0.027);皮瓣皮缘出现发黑情况两组比较,差异无统计学意义[5.0%(1/20)vs 30.0%(6/20),χ2=2.771,P=0.096]。结论腓肠神经营养血管皮瓣延迟转移术相对于腓肠神经营养血管皮瓣转移术,能够明显提高腓肠神经营养血管皮瓣的愈合评分,显著改善受瓣区位于踝关节平面以远的患者术后愈合情况,提高临床治疗效果。Objective To explore the impact of delayed-transposition of sural neurovascular flap. Methods Forty patients who accepted treatments at the department of burn surgery in Changhai Hospital from January 2009 to March 2012 were randomly divided into control group（ n = 20） and experimental group （n = 20）. The traditional transposition of sural neurovascular flap was used in control group and delayedtransposition of sural neurovascular flap was applied in experimental group. Patients received postoperative healing score, the evaluation criteria includes the days of wound healing after transposition of skin flap, the days of swelling of skin flap, the occurrence of vesicle of skin flap , the occurrence of skin flap necrosis, whether required reoperation. Then the authors compared the postoperative healing situation of the patients from the two groups. Results The days of swelling of skin flap [ （3.19 ±0.38）d] and the days of wound healing after transposition of skin flap[ （ 13.34 ± 0.21 ） d] was significantly less in experimental group than that in control group [ （5.54 ± 0. 35 ）d, （ 15.49 ±0.42）d, （t = -20. 355, -20. 637, P = 0. 001 ,0. 001 ） ] ; The occurrence of vesicle of skin flap , whether required reoperation was less in experimental group than that in control group [ 0.0% （0/20） vs 30. 0% （6/20） ,0. 0% （0/20） vs 30. 0% （6/20）, （χ^2 = 4. 902,4. 902, P =0. 027,0. 027） ] ; The color black occurrence of skin flap edges was no difference in two groups [5.0% （1/20） vs 30. 0% （6/20）, χ^2 =2. 771 ,P =0. 096]. Conclusions To the traditional ＂transposition of sural neurovascular flap＂, the ＂delayed-transposition of sural neurovascular flap＂ can significantly increase the healing score of sural neurovascular flap and significantly improve the postoperative healing, especially the skin flap is transferred, to the area of distal plane ankle. The ＂ delayed-transposition of sural neurovascular flap＂ can increase the therapeutic effects.

关 键 词：腓肠神经 外科皮瓣 延迟转移 

分 类 号：R658.3[医药卫生—外科学]