腹部皮管修复手指脱套伤的改进与疗效观察  

Effect of a modified abdominal tube on repairing finger degloving injury

作　　者：李斌[1] 肖孟景 邹晓防[1] 蔡景宁[1] 吴世建[1] 刘爽 Li Bin;Xiao Mengjing;Zou Xiaojang;Cai Jingning;Wu Shijian;Liu Shuang.(Department of Burns and Plastic Surgery, Air Force General Hospital, PLA, Beijing 100142, China)

机构地区：[1]空军总医院烧伤整形科,北京100142

出　　处：《中华损伤与修复杂志（电子版）》2018年第2期112-116,共5页Chinese Journal of Injury Repair and Wound Healing(Electronic Edition)

摘　　要：目的比较一种改进的腹部皮管方式与传统腹部皮管方式在修复手指脱套伤上的疗效。方法选取2011年1月至2013年12月期间在空军总医院烧伤整形科行手术治疗的单指脱套伤患者30例,按随机数字表法分为实验组和对照组,每组各15例。实验组采取改进腹部皮管方式进行手术,对照组采取传统腹部皮管方式进行手术,观察术后皮瓣肿胀、外观、感染、血运、感觉功能恢复等。采用SPSS 18.0统计软件分析数据,毛细血管充盈时间、感觉功能评分等计量资料组间比较采用t检验。结果两组皮瓣均成活良好。对照组1例术后10 d出现皮瓣边缘发黑坏死,经换药控制感染后恢复较好,实验组未出现此种情况。两组术后皮瓣均有不同程度肿胀,对照组肿胀更明显,且伴有发紫现象。两组术后均有少量渗出,经常规换药,未出现感染。实验组皮瓣毛细血管充盈时间较对照组明显缩短,术后7、14 d的毛细血管充盈时间,实验组(1.03±0.25)、(0.91±0.21)s较对照组[(1.24±0.33)、(1.18±0.39)s]明显缩短,差异有统计学意义(t=-1.995、-2.361,P=0.0495、0.0254)。术后6、12个月实验组皮瓣感觉功能评分(2.66±0.38)、(3.67±0.55)分显著优于对照组[(1.97±0.36)、(3.14±0.43)分],差异有统计学意义(t=5.105、2.940,P值均小于0.05)。结论治疗单指脱套伤时应用此种改进的腹部皮管与传统腹部皮管相比,能显著增加蒂部血运,减轻术后肿胀,改善皮瓣外观,感觉功能恢复更佳。Objective To compare a modified abdominal tube with traditional abdominal tube in the curative effect of repairing finger degloving injury. Methods Thirty patients with single finger degloving injuries admitted to Air Force General Hospital,PLA from January 2011 to December 2013 were divided into the experimental group and the control group according to the random number table, each contained15 cases. Patients in experimental group received operation of modified abdominal tube,whereas patients in control group received operation of traditional abdominal tube. The postoperative swelling in the skin flap,appearance,infection,blood supply,sensory function recovery were compared between two groups. SPSS18. 0 was used for statistical analysis. The comparison for measurement data was performed by t test.Results The flap in two groups both survived well. One edge of flap in control group appeared black,with good recovery after dressing change. The experimental group did not appear this kind of situation. The postoperative flap in two groups both appeared some degree of swelling and purple,which was more obvious in the control group,accompanied with cyanosis. The wounds in two groups both had a small amount of effusion,through regular dressing treatment,both survived well with no infection. The capillary filling time in flap of experimental group was significantly shortened as compared to that of control group [（ 1. 03 ±0. 25） s,（ 0. 91 ± 0. 21） s vs.（ 1. 24 ± 0. 33） s,（ 1. 18 ± 0. 39） s],at 7 and 14 days post operation,respectively,the differences were statistically significant（ t =-1. 995,-2. 361,P = 0. 0495,0. 0254）.The sensory function recovery in flap of experimental group was markedly improved as compared to that of control group[（ 2. 66 ± 0. 38） s,（ 3. 67 ± 0. 55） s vs.（ 1. 97 ± 0. 36） s,（ 3. 14 ± 0. 43） s ],at 6 and12 months post operation,respectively,the differences were statistically significant（ t = 5. 105,2. 940,with P values below 0. 05）. Conclusion Using this

关 键 词：手指脱套伤 腹部皮管 改良术式 蒂部血运 

分 类 号：R658.2[医药卫生—外科学]