重建指动脉终末背侧支行逆行岛状皮瓣修复对指端缺损患者感觉的影响  

Effect of Reconstruction of the Dorsal Branch of the End of the Digital Artery and Reverse Island Flap on the Sensation of the Fingertip Defect Patient

作　　者：艾呈斌 许鸿智[2] AI Chengbin(Chuxiong Hospital of Traditional Chinese Medicine,Yunnan Chuxiong 675000,Chin)

机构地区：[1]云南省楚雄州中医院骨一科,云南楚雄675000 [2]广东省中医院骨科,广东广州510000

出　　处：《河北医学》2018年第8期1315-1318,共4页Hebei Medicine

基　　金：广东省中医药局科研项目资助;(编号:粤中医[2017]4号)

摘　　要：目的:探讨重建指动脉终末背侧支、行逆行岛状皮瓣修复对指端缺损患者感觉的影响。方法:选取2015年1月至2016年12月在我院治疗的指端缺损患者70例,共计78指,均行重建感觉的指动脉终末背侧支逆行岛状皮瓣修复术,将神经分支和指固有神经残端吻合。结果:5例7指皮瓣于术后3d出现水疱,对症处理后愈合,其余皮瓣均顺利成活,创面Ⅰ期愈合;术后6个月浅感觉恢复情况高于术后3个月和1个月,有统计学差异(100.00%,76.92%,0.00%,P<0.05);术后1个月全部恢复深痛觉;术后6个月两点辨别觉为(5.48±1.14)mm,明显少于术后3个月(P<0.05);术后6个月皮瓣感觉恢复明显优于术后3个月和术后1个月(P<0.05),S4级比例达到23.08%。结论:重建感觉的指动脉终末背侧支逆行岛状皮瓣修复指端缺损,是一种有效的方法,可使皮瓣感觉恢复,但需要一定的时间。Objective： To explore the influence of reverse island flap pedicled with terminal dorsal branch of digital artery with sense reconstruction for repairing fingertip defects. Methods： From January 2015 to December 2016,70 patients with finger end defect were treated in our hospital. A total of 78 fingers were used for the reconstruction of the dorsal branch of the terminal dorsal branch of the finger artery. Results： In 5 cases,blisters appeared on the 7 finger-flaps in the third day after operation,healing after symptomatic treatment,the other flaps survived and woundsⅠhealed; After operation,the recovery rate of superficial sensation at 6 th month was higher than that at 3 rd month and 1 st month,and the difference was statistically significant（100.00%,76.92%,0.00 %,P0.05）; In the 1 st month after surgery,all the patients recovered deep pain;In the postoperative 6 th month,the two-point discrimination was（5.48 ± 1.14） mm,which was significantly less than that of the postoperative 3 rd month; In the postoperative 6 th month,the sensory recovery of the flaps was significantly better than that of postoperative 3 rd month and 1 st month（P 0. 05）,and the ratio of S4 reached to 23.08%. Conclusion： The reconstruction of sensory end dorsal branch island flap to repair the finger end defect is an effective way to restore the sensation of the skin flap,but it takes a certain time.

关 键 词：指动脉终末背侧支逆行岛状皮瓣 皮瓣缺损 感觉重建 

分 类 号：R658.2[医药卫生—外科学]