穿支皮瓣术与胸腹部带蒂皮瓣修复术治疗手外伤软组织缺损的疗效对比  

The Operating Approaches and Therapeutic Effect of Deep Inferior Epigastric Perforator Flap and Thoracic and Abdominal Pedicled Skin Flap in Repairing the Soft Tissue Defect of Hands

作　　者：窦邦现[1] 李红卫[1] 白晨平[1] DOU Bang-xian;LI Hong-wei;BAI Chen-ping(Department of orthopedics Zhengzhou Cit)

机构地区：[1]郑州市骨科医院,河南郑州450003

出　　处：《临床研究》2018年第6期24-26,共3页Clinical Research

摘　　要：目的探讨手外伤软组织缺损采用穿支皮瓣术与胸腹部带蒂皮瓣修复术对患者疗效的对比。方法选择40例郑州市骨科医院2015年8月~2018年2月收治的手外伤软组织缺损患者为研究对象,随机分为观察组和对照组,观察组患者采取穿支皮瓣修复术(观察组,n=20),对照组患者采取胸腹部带蒂皮瓣修复术(对照组,n=20),对比两组患者的治疗效果与并发症发生率。结果治疗后,两组皮瓣成活率较为理想,对比无明显差异(P>0.05);观察组19例(92%)术后愈合,愈合时间为(0.8±0.2)年,明显优于对照组的15例(72%)和(1.4±0.3)年,组间对比具统计学差异(P<0.05);治疗后,两组患者IL-6、IL-8、TNF-α较术前均有下降,观察组与对照组相比下降尤为明显(P<0.05);观察组治疗后的并发症发生率低于对照组(P<0.05)。结论手外伤软组织缺损患者采用穿支皮瓣修复术,疗效显著,愈合时间快,并发症少,具非常重要推广应用价值。Objective To summarize the existing evidence on the efficacy of deep inferior epigastric perforator flap and thoracic and abdominal pedicled skin flap in repairing the soft tissue defect of hands.Methods A total of 40 cases with soft tissue defect admitted in zhengzhou orthopaedic hospital from August 2015 to February 2018 were selected as the research objects, then they were randomly divided into the observation group and the control group,20 cases in each.The observation group of patients were conducted deep inferior epigastric perforator flap surgery, while the control group patients were adopted the thoracic and abdominal pedicled skin flap surgery. The therapeutic effect and complication rate between two groups were compared after surgery. Results After treatment, the survival rate of the two groups was ideal, with no significant difference（P〈 0.05）. In the observation group, 19 cases（92%） had postoperative healing, and the healing time was（0.8±0.2） years,which was significantly better than that of the control group [ 15 cases（72%） and（1.4 ＋ 0.3） years], with statistically significant differences between the groups（P 〈 0.05）. After treatment, the contents of IL-6, IL-8, TNF-α decreased in both groups, and the observation group was significantly decreased compared with the control group（P 〈 0.05）. The incidence of complications of observation group after treatment was lower than that in the control group（P 〈 0.05）. Conclusion In the patients with soft tissue defect of hand, deep inferior epigastric perforated flap can be used to repair the skin flap, with advantages of significant curative effect, fast healing time and the least complications.It is worth of applying in clinic practice.

关 键 词：穿支皮瓣术 胸腹部带蒂皮瓣修复术 手外伤软组织缺损 

分 类 号：R622.1[医药卫生—整形外科]