连续“Z”字成形术治疗掌腱膜挛缩症28例  

Continuous Z shape plasty in treatment of 28 cases of Dupuytren＆#39;s contracture

作　　者：虞泽珑[1] 陈荣国[1] 蒋纯志[2] 曾怿[1] 欧先锋[1] 钱建吉 

机构地区：[1]扬州大学医学院附属六合医院骨科,江苏南京211500 [2]南京医科大学附属南京第一医院骨科,江苏南京210006

出　　处：《实用手外科杂志》2016年第3期288-290,294,共4页Journal of Practical Hand Surgery

摘　　要：目的：探讨连续“Z”字成形术治疗掌腱膜挛缩症的临床疗效。方法筛选2007年6月-2014年6月收治的掌腱膜挛缩症患者48例，作为研究对象。分为对照组与观察组，对照组20例，观察组28例。对照组应用“齿”状切口、“Z”字切口、“S”形切口、“L”形切口、直切口＋“Z”字改形切口治疗掌腱膜挛缩症；观察组采用连续“Z”字成形术治疗掌腱膜挛缩症，比较两组患者并发症并通过随访复查统计其临床疗效。结果随访3个月~4年。对照组皮肤坏死率为35.0%（7／20），观察组皮肤坏死率为7.1％（2／28）。采用卡方检验比较统计两组之间的皮肤坏死率，χ2=4.255，P〈0.05，两组术后皮肤坏死率差异有显著统计学意义。结论连续“Z”字成形术治疗掌腱膜挛缩症可显著提升其临床疗效，降低术后皮肤坏死率，具有临床应用及推广价值。Objective To explore clinical effect of continuous Z-shape plasty in treatment of Dupuytren＇s contracture. Methods Selected 48 Dupuytren＇s contracture patients, who were treated from June 2007 to June 2014 in our hospital as the research object. They were divided into the experimental group and control group. There were 20 cases in the control group, and 28 cases in the experiment group. The control group was treated with dentate incision, Z shape incision, S shape incision, L shape incision or straight incision plus Z shape plasty incision. The experiment group adopted continuous Z shape plasty to treat Dupuytren＆#39;s contracture, counted curative effect through comparing complications and follow-up review after operation. Results All the patients were followed up from 3 months to 4 years. In the control group postoperative skin necrosis rate was 35.0%（7/20）, and 7.1%（2/28） in the experimental group. The Chi-square test was used to compare statistically the skin necrosis rate between the two groups, and the result showed the χ2 was 4.255, and P value was less than 0.05. The difference of postoperative skin necrosis rate between the two groups had a statistical significance. Conclusion Continuous Z shape plasty in the treatment of Dupuytren＇s contracture can significantly improve the clinical curative effect, and reduce the skin necrosis rate after operation. It is worthy of application and promotion in clinic.

关 键 词：掌腱膜挛缩 皮肤坏死 外科 手术 

分 类 号：R653.05[医药卫生—外科学]