两种转移皮瓣成形术治疗骶尾部藏毛窦  

Application of two types of flap transposition plasty in treatment of sacrococcygeal pilonidal sinus

作　　者：于锦利[1] 段宏岩 王凯[1] 蔡姮婧[1] 孙磊[1] 郝鹏[1] 

机构地区：[1]北京市肛肠医院(二龙路医院)肛肠外科外三病区,北京100120

出　　处：《新医学》2015年第3期157-161,共5页Journal of New Medicine

摘　　要：目的评价及比较2种转移皮瓣成形术治疗骶尾部藏毛窦的疗效。方法 96例骶尾部藏毛窦患者分别接受改良Limberg皮瓣成形术（Limberg组,28例）和改良Karydakis皮瓣成形术（Karydakis组,68例）治疗。记录和观察患者的手术时间、术后皮瓣坏死情况、伤口愈合情况、住院时间,术后随访至少3个月,观察复发情况。对2组数据进行比较。结果 Limberg组手术时间较Karydakis组长[中位数（四分位数间距）为110（3.75）min vs.90（40）min],皮瓣水泡、表皮坏死发生率较Karydakis组高（25%vs.0）,伤口一期愈合率低于Karydakis组（46%vs.71%）,住院时间长于Karydakis组[中位数（四分位数间距）为20（4.75）d vs.17（9）d]（P均〈0.05）。随访3~49（23.5）个月,2组复发率比较差异无统计学意义（P〉0.05）。结论改良Limberg皮瓣成形术及改良Karydakis皮瓣成形术均是治疗骶尾部藏毛窦的有效方法,改良Karydakis皮瓣成形术的疗效更好。Objective To compare the clinical efficacy of two types of flap transposition plasty in the treatment of sacrococcygeal pilonidal sinus. Methods A total of 96 patients with sacrococcygeal pilonidal sinus were divided into the modified Limberg flap plasty（ Limberg group,n = 28） and modified Karydakis flap plasty groups（ Karydakis group,n = 68）. The operation time,postoperative flap necrosis and wound healing,length of hospital stay were observed and recorded. Postoperative follow-up endured for ≥ 3 months. The recurrence rate of sacrococcygeal pilonidal sinus was observed. All these parameters were statistically compared between two groups. Results In the Limberg group,the operation time（ median： interquartile range） was110（ 3. 75） min,significantly longer than 90（ 40） min in the Karydakis group. The incidence of flap blister and epidermal necrosis was 25%,significantly higher compared with 0% in the Karydakis group. The percentage of patients with stage I wound healing was 46%,significantly less than 71% in the Karydakis group,and the length of hospital stay（ median： interquartile range） was 20（ 4. 75） d which was significantly longer compared with 17（ 9） d in the Karydakis group（ all P〈0. 05）. Time of follow-up ranged from 3 to 49 months（ 23. 5 month on average）. The recurrence rate did not significantly differ between two groups（ P〉0. 05）.Conclusions Albeit both modified Limberg and Karydakis flap plasty are efficacious treatment of sacrococcygeal pilonidal sinus,the clinical efficacy of the modified Karydakis flap plasty yields better clinical efficacy compared with the modified Limberg flap plasty.

关 键 词：藏毛窦 转移皮瓣 手术 疗效 

分 类 号：R657.1[医药卫生—外科学]