同指三种带蒂皮瓣修复指端（腹）缺损的中远期疗效对比  

Comparative study on the repair of digit tip injury and pulp loss by three kinds of flap in long-term effect

作　　者：薛俊红[1] 陈惠敏[1] 张艳敏[1] 范华波 李浩 胡娟[4] 

机构地区：[1]邯郸市中心医院手外科,河北邯郸056001 [2]邯郸钢铁有限责任公司职工医院骨科,河北邯郸056001 [3]中煤公司岭北医院,河北邯郸056001 [4]邯郸市第一医院,神经内科,河北邯郸056001

出　　处：《实用手外科杂志》2014年第4期407-409,共3页Journal of Practical Hand Surgery

摘　　要：目的：通过回顾性随访对修复指端（腹）缺损的同指三种皮瓣中远期疗效进行对比，为指端（腹）缺损创面的皮瓣修复提供最佳选择。方法将修复指端（腹）缺损的同指三种皮瓣分为3组：组1为同指顺行指动脉神经蒂皮瓣；组2为中节指动脉背侧支筋膜蒂皮瓣；组3为近节指背侧指动脉皮瓣。每组30例进行平均4.5年的随访。通过对皮瓣的满意度等9项指标进行对比。结果患者对三组的疗效均较满意，组1和组2、组3在实体综合感觉、两点辨别觉、畏寒病例数、出汗、供区情况方面有明显差异，组2和组3在畏寒病例数方面有差异。三组其他方面无明显差异。结论三种同指皮瓣均是修复指端（腹）缺损的可选方法，效果良好。综合各项指标对比，推荐按同指顺行指动脉神经蒂皮瓣→中节指动脉背侧支筋膜蒂皮瓣→近节指背指动脉皮瓣的顺序选择。Objective To compare the repairment effect of digit tip injury and pulp loss by three kinds of pedicle skin flap in long-term. Then the result will provide the best choice for digit tip injury and pulp loss. Methods The cases which had the digit tip injury and pulp loss repaired by two types of digital artery flapwere divided into 3 group, group 1 was anterograde digital artery flaps. Group 2 was pedicle of dorsal digital artery flaps of middle segment, group 3 was pedicel of dorsal digital artery flap of Proximal finger. 30 cases of each group were followed up for 4.5 years. A contrastive analysis of 9 index were made. This comparison consists of the satisfaction of the flaps. Results All patients were satisfactory with the effect, There was difference between group 1 and group 2 andgroup 3. The difference consist of stereognosis, two point discrim-pination, cases of chills, sweat, appearance of the donor sites. Group 2 and group 3 had difference in cases of chills. No significant difference between the three groups in other aspects. Conclusion These are good methods for using 3 different flaps to repair digit injury and pulp loss in long period. Good results coverd all the groups. Comparison of comprehensive indexes, anterograde digital artery flaps is the first choice of treatment then the pedicel of dorsal digital artery flaps of middle segment, at last pedicel of dorsal digital artery flap of Proximal finger.

关 键 词：手指缺损 修复 皮瓣 比较 远期疗效 

分 类 号：R658.2[医药卫生—外科学]