股薄肌肌瓣治疗老年人Ⅲ、Ⅳ度坐骨结节褥疮的疗效分析  

Effectiveness of gracilis muscle flap for treatment of degree 3 and 4 pressure ulcers on ischial tuberosities for elderly patients

作　　者：林炳远[1] 郭峭峰[1] 黄凯[1] 刘亦杨[1] 张春[1] 沈立锋[1] 

机构地区：[1]浙江省立同德医院骨科,杭州310012

出　　处：《中华老年医学杂志》2016年第9期982-985,共4页Chinese Journal of Geriatrics

摘　　要：目的探讨应用股薄肌肌瓣治疗老年人Ⅲ、Ⅳ度坐骨结节褥疮的临床疗效。方法自2010年1月至2015年6月共收治老年人坐骨结节褥疮19例，其中男性11例，女性8例；年龄62～86岁，年龄71．3岁；病程2～23个月，平均9．6个月；根据美国国家褥疮顾问小组（NPUAP）标准分度：Ⅲ度7例，Ⅳ度12例。全部病例在病灶清除后应用股薄肌肌瓣修复创面。结果所有肌瓣均顺利成活，无坏死；切口I期愈合17例，切口术后裂开2例，经过换药对症治疗后愈合。术后所有病例均获得随访，随访时间6个月至5年。19例患者中，褥疮复发1例，经过清创缝合后愈合；其余患者褥疮均未复发。结论应用股薄肌肌瓣治疗老年人Ⅲ、Ⅳ度坐骨结节褥疮疗效显著，治愈率高，值得临床推广应用。Objective To discuss effectiveness of gracilis muscle flap for treatment of degree 3 and 4 pressure ulcers on ischial tuberosities for elderly patients. Methods From January 2010 to June 2015,19 elderly patients with pressure ulcers on the ischial tuberosities were enrolled,including 11 males and 8 females with an average age of 71.3 years ranging 62 to 86 years. The average course of disease was 9.6 months ranging 2 to 23 months,including 7 cases of degree 3 and 12 cases of degree 4 according to the National Pressure Ulcer Advisory Panel （NPUAP）. All cases were treated by gracilis musle flap after debridement. Results All muscle flaps survived without necrosis,2 cases had wound dehiscence after operation and were healed after symptomatic treatment, and the 17 wounds were healed for first intention. All patients were followed up for 6 months to 5 years. Pressure ulcer on the ischial tuberosities recurred in 1 case after operation and was healed by debridement and suture. Pressure ulcers did not recur in the rest cases. Conclusions Gracilis muscle flap in the treatment of degree 3 and 4 pressure ulcers on the ischial tuberosities has remarkable curative effect and high cure rate in elderly patients,it is worthy of clinical application.

关 键 词：压力性溃疡 坐骨 

分 类 号：R632.1[医药卫生—外科学]