第一掌骨颈桡侧穿支皮瓣游离移植修复36例手指软组织创面的临床效果  

Clinical effect of 36 cases of finger soft tissue wounds repaired by free transplantation of the first metacarpal cervical radialis perforator flap

作　　者：裴少琨 张亚斌 李敏杰 PEI Shao-kun;ZHANG Ya-bin;LI Min-jie(Orthopedics Department,the Fourth People's Hospital of Shaanxi,Xi'an 710043,China)

机构地区：[1]陕西省第四人民医院骨科,陕西西安710043

出　　处：《临床医学研究与实践》2019年第9期3-5,共3页Clinical Research and Practice

基　　金：陕西省科技攻关项目(No.2012K16-09-07)

摘　　要：目的探讨第一掌骨颈桡侧穿支皮瓣游离移植修复36例手指软组织创面的临床效果。方法采用分层抽签方式分别从拟在本院接受腹部带蒂皮瓣修复术(对照组)和接受第一掌骨颈桡侧穿支游离皮瓣修复术(观察组)进行手指软组织损伤修复治疗的患者中抽取36例作为研究对象。对比两组治疗效果。结果观察组患指屈伸功能受限患者占比明显低于对照组,两点辨识距离、血运和外形美观评分显著高于对照组(P<0.05)。观察组患指修复优良率高于对照组(P<0.05)。术后1周,两组HAMA及NRS评分均明显降低,且观察组低于对照组(P<0.05)。观察组的术后并发症总发生率低于对照组(P<0.05)。结论第一掌骨颈桡侧穿支游离皮瓣修复手指软组织损伤皮瓣成活率高,患指功能恢复及外观好,临床效果佳。Objective To investigate the clinical effect of 36 cases of finger soft tissue wounds repaired by free transplantation of the first metacarpal cervical radialis perforator flap.Methods Patients who underwent abdominal pedicle flap repair in the hospital(control group)and the first metacarpal cervical radialis perforator free flap repair(observation group)for the treatment of finger soft tissue injury were selected as research objects by stratified drawing,with 36 cases in each group.The therapeutic effects of the two groups were compared.Results The proportion of patients with limited flexion and extension of fingers in the observation group was significantly lower than that in the control group,and the scores of two-point identification distance,blood supply and aesthetic appearance were significantly higher than those in the control group(P<0.05).The excellent and good rate of finger repair in the observation group was higher than that in the control group(P<0.05).One week after operation,the HAMA and NRS scores of the two groups decreased significantly,and those of the observation group were lower than the control group(P<0.05).The total incidence of postoperative complications in the observation group was lower than that in the control group(P<0.05).Conclusion The first metacarpal cervical radialis perforator free flap has high survival rate in repairing finger soft tissue injury,good functional recovery and appearance of the affected finger,and good clinical effect.

关 键 词：手指 软组织缺损 皮瓣修复 穿支皮瓣 显微外科 

分 类 号：R658.2[医药卫生—外科学]