全拔甲后甲板回植术及部分拔甲术与传统全拔甲术的对比评价  

The Comparison and Evaluation of Partial Nail Avulsion and Total Nail Avulsion with Plate Replacement with Traditional Total Nail Avulsion

作　　者：薛斯亮[1] 梅蓉[1] 武丹[1] 吕熙[2] 

机构地区：[1]四川大学华西医院皮肤科,成都610041 [2]四川大学学报(医学版)编辑部,成都610041

出　　处：《四川大学学报（医学版）》2017年第1期151-153,171,共4页Journal of Sichuan University(Medical Sciences)

基　　金：国家自然科学基金青年基金(No.81502747)资助

摘　　要：目的比较保留甲板的全拔甲后甲板回植术和部分拔甲术与传统全拔甲术的区别。方法患者由随机数字表分配到传统全拔甲组(对照组)、部分拔甲组、全拔甲后甲板回植术组(全拔甲回植组),每组20例,分别行不同拔甲手术。比较3种术后患者疼痛、甲床完全愈合时间、甲板完全生长时间、甲完全生长后结果评分。结果3组患者基线差异无统计学意义。术后8h,对照组患者疼痛评分高于其他两组(P<0.05)。术后48h,部分拔甲组20例患者疼痛全部消失,而全拔甲回植组90%(18/20)患者疼痛消失,高于对照组的45%(9/20)。创面愈合时间:对照组>全拔甲回植组>部分拔甲组(P<0.05)。甲板完全生长时间:部分拔甲组最短,对照组最长,全拔甲回植组居中但与前两者比较差异无统计学意义。对照组甲板恢复最后效果的评分低于部分拔甲组和全拔甲回植组(P<0.05),而后两组评分差异无统计学意义。结论部分拔甲术可减少甲板缺失,对甲床的损伤较少,疼痛较轻,可加快愈合,改善预后。而在需要大面积暴露甲床,不得不全拔甲的时候,应在术后将甲板回植,可获得更好的疗效。Objective To determine the different effects of partial nail avulsion and total nail avulsion with plate replacement with traditional total nail avulsion. Methods Patients were divided into three groups randomly （ n=20）： total nail avulsion group （control group）, partial nail avulsion group,and total nail avulsion with plate replacement group （nail replacement group）. The rating of pain 〔visual analogue scale （VAS） score〕, the wound healing time, the nail growth time ,and the score of satisfaction were analyzed. Results The baseline data of three groups had no significant difference. From 8 h, VAS score of partial nail avulsion group and nail plate replacement group was different with that in control group （ P〈0.05）. 48 h after surgery, the pain disappeared totally in partial nail avulsion group, largely in nail replacement group 〔90%（18/20）〕 ,which were both significantly different with that of control group 〔45%（9/20）〕（ P〈0.05）. Healing time of three groups was listed as follow： control group〉nail replacement group〉partial nail avulsion group （ P〈0.05）. Nail growth time was the longest in control group, the shortest in partial nail avulsion group （ P〈0.05, vs. control group）, and median in nail replacement group. The score of satisfaction in control group was lower than that in partial avulsion group and nail replacement group（ P〈0.05）, of the later two there was no statistic difference. Conclusion By decreasing the defect of nail plate and the injury of nail bed, and by smoothing the pain, partial nail avulsion benefits the wound-healing. Nail plate should be replace to get further benefits.

关 键 词：拔甲术 部分拔甲 甲回植 

分 类 号：R751.05[医药卫生—皮肤病学与性病学]