改良骨间背侧动脉穿支游离皮瓣修复手部掌侧软组织缺损的效果  

Effects of modified interosseous dorsal artery free perforator flaps in repair of hand palmar soft tissue defect

作　　者：郑佐慧 谭志伟[1] 肖志林 郑永才[1] 罗焕明[1] 梁晓兰[1] 冯经旺 ZHENG Zuo-hui;TAN Zhi-wei;XIAO Zhi-lin;ZHENG Yong-cai;LUO Huan-ming;LIANG Xiao-lan;FENGJing-wang(Department of Orthopedic,the Sixth People ＇s Hospital of Nanhai District in Foshan City,Guangdong Province,Foshan 528248,China)

机构地区：[1]广东省佛山市南海区第六人民医院骨科,广东佛山528248

出　　处：《中国当代医药》2018年第16期90-92,共3页China Modern Medicine

基　　金：广东省佛山市医学科研立项课题(20170190)

摘　　要：目的研究改良骨间背侧动脉穿支游离皮瓣修复手部掌侧软组织缺损的临床效果和对患者术后感觉功能和外观形态的影响。方法将我院2017年1~12月收治的30例手部掌侧软组织缺损患者作为研究对象,采用系统随机化法分为改良组(n=15)和常规组(n=15),其中改良组行改良骨间背侧动脉穿支游离皮瓣修复术,常规组采用骨间背侧动脉游离皮瓣修复术治疗,比较两组的手术效果。结果改良组术中出血量和住院天数少于常规组,差异均有统计学意义(P<0.05);术后痛觉、温度觉、触压觉评分高于常规组,差异有统计学意义(P<0.05),二点分辨觉距离小于常规组,差异有统计学意义(P<0.05),外观形态和VAS评分高于常规组,差异有统计学意义(P<0.05),术后并发症少于常规组,差异有统计学意义(P<0.05)。结论改良骨间背侧动脉穿支游离皮瓣修复手部掌侧软组织缺损效果明显,可有效减少术后并发症,提高患者恢复速度,同时还能改善感觉功能恢复,提高术后美观效果。Objective To study the clinical effects of modified interosseous dorsal artery free perforator flaps in the repair of soft tissue defect of hand palm and its influence on postoperative sensory function and appearance morphology.Methods A total of 30 cases of patients with soft tissue defect of hand palm admitted to our hospital from January to December 2017 were selected for the study subjects and were divided into the modified group（n=15） and the routine group（n =15） according to system randomization method.The modified group was given modified interosseous dorsal artery free perforator flaps repair,and the routine group was given interosseous dorsal artery free perforator flaps repair.The surgical effects were compared between the two groups.Results The intraoperative blood loss and hospital stay in the modified group were lower than those in the routine group（P〈0.05）.The scores of postoperative pain,temperature sensation and touch pressure sensation were higher than those in the routine group（P〈0.05）,while the two-point resolution distance was lower than that in the routine group（P〈0.05）,and the scores of appearance and VAS were higher than those in the routine group（P〈0.05）,while the postoperative complications were lower than those in the routine group,the differences were statistically significant（P〈0.05）.Conclusion Modified interosseous dorsal artery free perforator flaps can have good effects in the repair the soft tissue defects of the hand palm,and it can not only effectively reduce the postoperative complications and promote patient rehabilitation,but also improve the sensory function recovery and postoperative esthetic effect.

关 键 词：手部掌侧损伤 软组织缺损 皮瓣修复 穿支皮瓣 骨间背侧动脉 

分 类 号：R658.2[医药卫生—外科学]