Flow-through静脉皮瓣在伴环形缺损断指再植中的应用  

The application of flow-through vein flap in the replantation of circular defect

作　　者：赵建武[1] 陈强 白晓兵[1] 蔡飞 刘鹏[1] ZHAO Jian-wu;CHEN Qiang;BAI Xiao-bing(The first hospital in yulin,Yulin Shaanxi 719000,China.)

机构地区：[1]陕西省榆林市第一医院手足显微外科,陕西榆林719000

出　　处：《临床和实验医学杂志》2018年第18期1992-1995,共4页Journal of Clinical and Experimental Medicine

基　　金：陕西省卫生厅科研基金资助项目(编号:2012D13)

摘　　要：目的评价Flow-through静脉皮瓣在伴环形缺损断指再植中的临床应用价值。方法采用前瞻性随机对照研究法,将榆林市第一医院手足显微外科自2015年6月至2016年10月收治的70例伴环形皮肤及血管缺损的断指再植患者随机分为两组,对照组(n=35)采用侧方皮瓣修复治疗,观察组(n=35)采用Flow-through静脉皮瓣修复治疗,两组患者均随访12个月,比较两组患者的治疗效果、两点辨别感觉以及不良预后发生情况。结果观察组的末次随访手指功能优良率高于对照组(P<0.05);观察组的末次随访时两点辨别感觉为6.5~12.5 mm,平均(8.5±1.3)mm,对照组的末次随访时两点辨别感觉为7.5~14.0 mm,平均(10.4±1.5)mm,组间比较差异有统计学意义(P<0.05);观察组的静脉危象、弹性变差、颜色加深等不良预后发生率均低于对照组(P<0.05)。结论与侧方皮瓣修复治疗相比,采用Flow-through静脉皮瓣修复治疗伴环形皮肤及血管缺损断指的临床效果更佳,不良预后发生率更低;若临床条件允许,对于伴环形皮肤及血管缺损的断指再植患者,建议优先采用Flow-through静脉皮瓣修复治疗。Objective To evaluate the clinical application value of flow-through intravenous flap in the replantation of annulus defect.Methods A prospective randomized double-blind control study was performed in Yulin First Hospital from June 2015 to October 2016,70 cases of patients with annular skin and vascular defects were randomly divided into two groups,the control group（n = 35） with lateral skin flap repair treatment,observation group（n = 35） using Flow-through vein flap repair treatment and they were followed up for 12 months. The prognosis and sensory discrimination were observed. Results At the end of the follow-up finger function excellent rate of observation group was higher than that in control group（P〈0. 05）. At the end of the follow-up sensory discrimination of observation group was 6. 5 - 12. 5 mm,average（8. 5 ± 1. 3）mm,at the end of the follow-up sensory discrimination of the control group was 7. 5 - 14. 0 mm,average（10. 4 ± 1. 5） mm,there was statistically significant difference between groups（P〈0. 05）,at the end of the follow-up finger function excellent rate of observation group was higher than that in control group（P〈0. 05. Prognosis of the observation group,venous crisis elasticity variation,deepening the color were lower than the control group（P〈0. 05）. Conclusion The clinical effect of flow-through intravenous flap repairing circular skin and vascular defect is better,and the incidence of poor prognosis is lower. If clinical conditions permit,it is recommended to use the flow-through vein flap for treatment of patients with annulus and vascular defects.

关 键 词：断指再植 环形皮肤及血管缺损 Flow-through静脉皮瓣 疗效 不良预后 

分 类 号：R658.1[医药卫生—外科学]