不同构制的拇指尺背侧逆行桡神经浅支营养血管皮瓣的比较研究  

A comparative study of the different configurations of reverse superficial radial nerve neurocutaneous flap on dorsoulnar aspect of the thumb

作　　者：张蕾 杨英才 王博 

机构地区：[1]山西省运城市中心医院手足外科,044000

出　　处：《中华手外科杂志》2014年第5期350-351,共2页Chinese Journal of Hand Surgery

摘　　要：目的 比较不同构制的拇指尺背侧逆行桡神经浅支营养血管皮瓣修复拇指软组织缺损的疗效.方法 应用拇指尺背侧逆行桡神经浅支营养血管皮瓣修复拇指软组织缺损31例,其中11例（A组）仅保留较窄的筋膜蒂,未保留较粗大的连续性良好的指背静脉;20例（B组）设计皮瓣蒂部筋膜较宽且包含较粗的有完整连续性的指背静脉.结果 A组中3例术后皮瓣发紫,3～4d后恢复,1例部分发黑坏死;B组无术后皮瓣发紫现象,全部存活.结论 保留较粗的有完整连续性的指背静脉筋膜蒂能明显降低术后皮瓣发紫概率,提高皮瓣成活率.Objective To compare the surgical results of different configurations of reverse superficial radial nerve neurocutaneous flap on dorsoulnar aspect of the thumb in repairing soft tissue defects of the thumb.Methods A total of 31 cases of soft tissue defects of the thumb were treated with reverse superficial radial nerve neurocutaneous flap on dorsoulnar aspect of the thumb.In 11 cases （group A） only a narrow fascia pedicle was retained without including a substantial dorsal vein in the flap.In 20 cases （group B） a wider fascia pedicle was designed to include a continuous,thick dorsal vein.Results Postoperative venous congestion occurred in 3 cases of group A causing the flaps to turn purple.The congestion subsided in 3 to 4 days.Partial skin necrosis was found in one of these cases.No venous congestion was noted in group B.All the flaps survived uneventfully.Conclusion Including a continuous,thick dorsal vein within the fascia pedicle can significantly reduce postoperative venous congestion and improve flap survival.

关 键 词：外科皮瓣 拇指 桡神经浅支营养血管 软组织缺损 

分 类 号：R658.2[医药卫生—外科学]