前臂带蒂旋转皮瓣修复手背创面的疗效分析  

Therapeutic effects of the forearm pedicled rotation flap surgery in the repair of wound surface of back of hand

作　　者：何奎乐 边朝辉 郑俊生 姜建忠 史志刚 金硕 HE Kuile;BIAN Chaohui;ZHENG Junsheng(Department of Osteology,People＇ s Hospital of Renqiu City,Hebei,Renqiu 062550,Chin)

机构地区：[1]河北省任丘市人民医院骨二科,062550

出　　处：《河北医药》2018年第17期2631-2634,共4页Hebei Medical Journal

基　　金：沧州市科学技术研究与发展支撑计划项目(编号:172302206)

摘　　要：目的观察前臂带蒂旋转皮瓣修复手背创面的临床疗效。方法选取收治的手背创伤患者120例,随机分为对照组和研究组,每组60例。对照组采用前臂带蒂旋转皮瓣修复手背创面的治疗方法,研究组采用其他带蒂旋转皮瓣修复手背创面的治疗方法。观察2组皮瓣成活情况、创面愈合率、创面愈合时间、创面皮肤血运恢复时间、住院时间、满意度及并发症发生情况;比较2组治疗前后手部关节活动度变化。结果对照组皮瓣成活率、优良率分别为88.33%、65.00%,研究组皮瓣成活率、优良率分别为100%、88.33%;研究组皮瓣成活率、优良率较对照组显著提高(P<0.05)。2组治疗后7 d、28 d创面愈合率比较差异无统计学意义(P>0.05),研究组治疗后14 d、21 d创面愈合率较对照组显著提高(P<0.05)。研究组创面愈合时间、创面皮肤血运恢复时间、住院时间较对照组显著缩短,满意度较对照组显著提高,术后并发症发生率较对照组显著降低(P<0.05)。治疗前2组手部关节活动度比较差异无统计学意义(P>0.05);治疗后2组手部关节活动度均较治疗前显著增加,差异有统计学意义(P<0.05),且研究组手部关节活动度变化程度大于对照组(P<0.05)。结论前臂带蒂旋转皮瓣修复手背创面疗效确切,能够有效促进手部功能恢复,降低术后并发症发生率,值得临床推广应用。Objective To observe the therapeutic effects of the forearm pedicled rotation flap surgery in the repair of wound surface of back of hand. Methods A total of 120 patients with back of hand wound who were admitted and treated in our hospital from May 2010 to December 2016 were enrolled in the study. These patients were randomly divided into control group（ n = 60） and research group（ n = 60）. The patients in control group were treated by the other pedicled rotation flap surgery,however,the patients in research group were treated by forearm pedicled rotation flap surgery. The survival rate of skin flap,wound surface healing rate, wound surface healing time, wound surface skin blood supplying recovery time,hospitalization time,satisfactory degree and incidence of complications were observed and compared between the two groups.Moreover the changes of motion of hand joint before surgery and after surgery were also observed and compared between two groups. Results After the surgery,the survival rate of skin flap and excellent rate in control group were 88. 33% and65. 00%,respectively,which in research group were 100% and 88. 33%,respectively,and the survival rate of skin flap and excellent rate in research group were significantly higher than those in control group（ P 〈 0. 05）. There were no significant differences in wound surface healing rates between the two groups at 7 d and 27 d after operation（ P 〉 0. 05）. However the wound surface healing rates in research group at 14 d and 21 d after operation were significantly higher than those in control group（ P 〈 0. 05）. Moreover the wound surface healing time, wound surface skin blood supplying recovery time,hospitalization time in research group were significantly shorter than those in control group,and satisfactory degree was higher than that in control group,and the incidence rates of postoperative complications in research group were significantly decreased,as compared with those in control group（ P 〈 0. 05）. Before surgery,there was no

关 键 词：皮瓣修复术 手部 创面修复 治疗结果 

分 类 号：R682.15[医药卫生—骨科学]