携带腓肠外侧皮神经的游离腓动脉穿支皮瓣修复在手足部软组织缺损中的应用  

Application of Free Peroneal Artery Perforator Flaps with Lateral Sural Cutaneous Nerve in Repairing Soft Tissue Defects of Hand and Foot

作　　者：罗贤军 LUO Xianjun(Guangji Hospital of Zhongshan City,Zhongshan 528427,Chi)

机构地区：[1]广东省中山市广济医院,广东中山528427

出　　处：《中国医学创新》2019年第2期151-154,共4页Medical Innovation of China

基　　金：中山市医学科研项目(2017A020007)

摘　　要：目的:探讨携带腓肠外侧皮神经的游离腓动脉穿支皮瓣修复在手足部软组织缺损中的应用。方法:选取2016年6月-2017年5月本院收治的手足部软组织缺损患者15例为研究组,2015年6月-2016年5月本院收治的手足部软组织缺损患者15例为对照组。对照组分别接受腹部带蒂皮瓣、游离足背皮瓣、游离股前外侧皮瓣、腓肠神经营养血管逆行皮瓣、股前外侧皮瓣修复,研究组接受携带腓肠外侧皮神经的游离腓动脉穿支皮瓣修复治疗。比较两组患者对外观恢复的满意情况、皮瓣成活率及皮肤弹性、瘢痕评分、感觉功能恢复及并发症情况。结果:研究组皮瓣成活率高于对照组(P<0.05);研究组对外观恢复的总满意度为100%,高于对照组的66.7%(P<0.05);术后3、6个月,研究组瘢痕评分均低于对照组(P<0.05),但两组皮肤弹性评分比较差异无统计学意义(P>0.05);术后6、12个月,研究组的感觉正常患者例数均多于对照组(P<0.05);研究组术后并发症的发生率为13.3%,明显低于对照组的73.3%(P<0.05)。结论:携带腓肠外侧皮神经的游离腓动脉穿支皮瓣修复治疗手足部软组织缺损的效果理想,临床上应当进一步推广应用。Objective:To explore the application of free peroneal artery perforator flaps with lateral sural cutaneous nerve in repairing soft tissue defects of hand and foot.Method:A total of 15 patients with soft tissue defect of hand and foot from June 2016 to May 2017 in our hospital were selected as study group,and 15 patients with soft tissue defect of hand and foot from June 2015 to May 2016 as control group.The control group was treated with abdominal pedicled skin flap,free dorsal foot skin flap,free anterolateral thigh skin flap,sural neurotrophic vessel retrograde skin flap and anterolateral thigh skin flap respectively,and study group received free peroneal artery perforator flaps with lateral sural cutaneous nerve.The satisfaction of appearance recovery,survival rate of skin flaps,skin elasticity,scar score,sensory function recovery and complications between two groups were compared.Result:The survival rate of flaps in study group was higher than that of control group(P<0.05).The total satisfaction rate of study group was 100%,which was higher than 66.7%of control group(P<0.05).After operation 3 and 6 months,the scar scores in study group were lower than those of control group(P<0.05),but the skin elasticity scores of two groups was compared,the difference was not statistically significant(P>0.05).After operation 6 and 12 months,the number of patients with normal sensation in study group were higher than those of control group(P<0.05).The incidence of postoperative complications was 13.3%in study group,which was significantly lower than 73.3%in control group(P<0.05).Conclusion:The free peroneal artery perforator flaps with lateral sural cutaneous nerve is an ideal treatment for soft tissue defect of hand and foot,it should be further popularized and applied in clinic.

关 键 词：腓肠外侧皮神经 游离腓动脉 感觉功能 手足部软组织缺损 

分 类 号：R658[医药卫生—外科学]