腓肠神经血管皮瓣联合重组人酸性成纤维细胞生长因子修复足跟区皮肤软组织缺损  

Therapeutic effects and safety of sural neurovascular flap surgery combined with rh-a FGF in repairing the skin and soft tissue defects in heel area

作　　者：刘建宁[1] 刘玉昌[1] 齐向北[1] 王伟[1] 徐国辉[1] LIU Jianning, LIU Yuchang, QI Xiangbei(Department of Osteology,Xiangjiang Braneh of the Third Hospital of Hebei Medical University, Hebei, Shijiazhuang 050000, Chin)

机构地区：[1]河北医科大学第三医院湘江院区骨科,石家庄市050000

出　　处：《河北医药》2018年第16期2516-2518,共3页Hebei Medical Journal

摘　　要：目的评价腓肠神经血管皮瓣联合rh-a FGF修复足跟区皮肤软组织缺损的有效性与安全性。方法选择2015年6月至2017年6月足跟区皮肤软组织缺损42例,随机分为治疗组和对照组,每组21例。对照组行远端蒂腓肠神经营养血管皮瓣修复治疗,治疗组在对照组基础上对皮瓣及植皮区同时给予rh-a FGF预处理及术后换药。术后随访1个月,观察皮瓣存活情况、皮瓣移植后并发症及创面愈合情况。结果治疗组皮瓣成活面积显著高于对照组[(98.4±12.8)%vs(89.4±13.7)%],受区完全愈合时间[(9.4±2.4)d vs(13.8±4.6)d]供区完全愈合时间[(11.4±4.2)d vs(16.7±6.8)d]显著短于对照组,2组比较差异有统计学意义(P<0.05)。治疗组水肿评分、渗出评分、皮瓣暗紫评分分别为1.4±0.7,1.1±0.2,1.3±0.4,对照组三项评分则分比为2.6±0.3,2.2±0.3,2.8±0.6。治疗组评分明显低于对照组,差异有统计学意义(P<0.05)。随访30 d内,治疗组发生感染的病例为1例,发生率为4.7%,对照组发生感染的病例为8例,感染率为28.5%,2组比较差异有统计学意义。随访30 d显示,治疗组感觉评分为(8.2±1.4)分,对照组为(5.2±1.3)分,2组比较差异有统计学意义(P=0.021)。另外2组治疗过程均未发生明显的不良反应。结论 rh-a FGF预处理联合术后换药干预皮瓣及植皮区有利于皮瓣存活、减少皮瓣移植后并发症发生,促进皮瓣的愈合。Objective To evaluate the therapeutic effects and safety of sural neurovascular flap surgery combined with rh-a FGF in repairing the skin and soft tissue defects in heel area. Methods A total 42 patients with skin and soft tissue defects in heel area. Who were treated in our hospital from June 2015 to June 2017 were randomly divided into treatment group（ n = 21） and control group（ n = 21）. The patients in control group were treated by distal stem sural neurovascular flap repair,however,the patients in treatment group,on the basis of control group,were treated by rh-a FGF pretreatment and postoperative change dressings. After 1-month treatment,the flap survival status,complications and wound healing status were observed and compared between two groups. Results After treatment,the flap survival area in treatment group was significantly higher than that in control group [（ 98. 4 ± 12. 8） % vs（ 89. 4 ± 13. 7） % ],and the complete healing time in recipient area [（ 9. 4 ±2. 4） d vs（ 13. 8 ± 4. 6） d] and complete healing time in donor area in treatment group were significantly shorter than those in control group [（ 11. 4 ± 4. 2） d vs（ 16. 7 ± 6. 8） d],there were significant differences between the two groups（ P〈0. 05）.Moreover the edema scores,oozing scores,dark purple flap scores in treatment group were 1. 4 ± 0. 7,1. 1 ± 0. 2,1. 3 ± 0. 4,respectively,which in control group were 2. 6 ± 0. 3,2. 2 ± 0. 3,2. 8 ± 0. 6,respectively,which in treatment group were significantly lower than those in control group（ P〈0. 05）. During 30-day follow up,there was 1 case of infection in treatment group,with the incidence rate of infection being 4. 7%,however,there were 8 cases of infection in control group,with the incidence rate of infection being 28. 5%,there was a significant difference between the two groups. Moreover the feeling scores in treatment group were（ 8. 2 ± 1. 4） points,which in control group were（ 5. 2 ± 1. 3） points,there were significant differences bet

关 键 词：腓肠神经血管皮瓣 重组人酸性成纤维细胞生长因子 存活率 

分 类 号：R622.12[医药卫生—整形外科]