指掌侧固有动脉背侧支皮瓣在手指皮肤缺损皮瓣修复中的应用价值  

The Application Value of the Dorsal Branches Island Flaps of the Proper Palmar Digital Arteries in Repairing Finger Tissue Defects

作　　者：李琳[1] 黄新 刘颖芝[1] LI Lin;HUANG Xin;LIU Ying-zhi(Department of Burn and Plastic Surgery,Minzu Hospital of Guangxi Zhuang Autonomous Region,Nanning 530001,Guangxi,China)

机构地区：[1]广西壮族自治区民族医院烧伤整形科

出　　处：《中国现代手术学杂志》2019年第2期126-130,共5页Chinese Journal of Modern Operative Surgery

摘　　要：目的探讨指掌侧固有动脉背侧支皮瓣在手指皮肤缺损皮瓣修复中的应用价值。方法选取我院 2014 年 4 月~2017 年 4 月收治的手指皮肤缺损患者 100 例( 100 指),并根据随机数字表法分成观察组与对照组各 50 例( 50 指)。对照组采用腹部皮瓣、交臂皮瓣、胸部皮瓣等修复,观察组采用指掌侧固有动脉背侧支皮瓣。比较两组手术时间、住院时间、两点辨别觉、治疗费用。在术后 6 个月患者复查时评价两组皮瓣修复效果,并分析触觉、冷觉、热觉、痛觉恢复效果,及术后患指美观度。结果观察组住院时间短于对照组,两点辨别觉短于对照组,治疗费用少于对照组,差异有统计学意义( P<0.05)。观察组术后 6 个月的皮瓣修复评分高于对照组,差异有统计学意义( P<0.05)。观察组术后 6 个月触觉、温度觉恢复效果优于对照组,差异有统计学意义( P<0.05)。观察组术后患指美容效果优良率为 98%,高于对照组的 66%,差异有统计学意义( P<0.05)。结论与腹部皮瓣等其他常用皮瓣相比,指掌侧固有动脉背侧支皮瓣的两点辨别觉更好,能进一步改善患指的皮肤质地,促进感觉功能恢复,术后美容效果更好。Objective To explore the application value of the dorsal branches island flaps of the proper palmar digital arteries in repairing finger tissue defects. Methods 100 cases ( 100 fingers) of finger tissue defect patients were selected from April 2014 to April 2017 in our hospital. 50 cases ( 50 fingers) of the observation group and 50 cases ( 50 fingers) of the control group were divided according to the random number table. The control group was repaired with abdominal skin flaps,cross-arm skin flaps or chest skin flaps.In the observation group,the the dorsal branches island flaps of the proper palmar digital arteries were used. Operation time,hospitalization stay,two point discrimination and the treatment cost were compared between the two groups. The results of the flaps were evaluated 6 months after operation,and the effects of the recovery of touch,temperature,pain and the aesthetic degree of affected fingers were analyzed. Results It showed advantages in the hospitalization stay,the two point discrimi- nation and the treatment cost in the observation group ( P<0.05). The score of the skin flap repair of the observation group was higher than that in the control group 6 months after operation,and the difference was statistically signifi- cant( P<0.05). The recovery rates of touch,temperature,pain and the aesthetic degree of affected fingers were higher in the observation group ( P<0.05).The excellent and good rate of cosmetic effect in the observation group was 98%,which was higher than 66% in the control group( P<0.05). Conclusion Compared with abdominal flaps,the dorsal branches island flaps of the proper palmar digital arteries has better two-point discrimination ability,better skin texture of injured fingers,higher recovery rates of sensory functions,and better postoperative cosmetic effects.

关 键 词：背侧支 指掌侧固有动脉 筋膜蒂岛状皮瓣 指皮肤缺损 

分 类 号：R622[医药卫生—整形外科] R658.2[医药卫生—外科学]