前臂游离动脉化静脉皮瓣在手部软组织缺损修复术中的应用研究  

Application of forearm free arterialized venous flaps in the repair of soft tissue defect of hand

作　　者：黄昱 刘圣曜 刘伟 罗人彰 杨帅智 HUANG Yu;LIU Shengyao;LIU Wei;LUO Renzhang;YANG Shuaizhi(The Fifth People′s Hospital of Foshan City,Foshan 528000,Guangdong,China)

机构地区：[1]广东省佛山市第五人民医院

出　　处：《微创医学》2019年第6期702-705,724,共5页Journal of Minimally Invasive Medicine

基　　金：广东省医学科学技术研究基金(编号:A2018032);佛山市卫生和计生局医学科研课题项目(编号:20190156)

摘　　要：目的探讨前臂游离动脉化静脉皮瓣在手部软组织缺损修复术中的应用效果。方法选择手部软组织缺损患者90例为观察对象,其中对照组(n=45)采用前臂远端掌侧动脉化静脉皮瓣修复术治疗,观察组(n=45)采用前臂游离动脉化静脉皮瓣修复术治疗。对比两组的临床效果。结果观察组皮瓣成活率明显高于对照组(97.78%vs.82.22%),皮肤恢复正常率高于对照组(95.56%vs.82.22%),愈合时间及皮瓣两点辨别觉均显著短/小于对照组,且不良反应发生率明显低于对照组(4.44%vs.13.33%)(均P<0.05)。术后1周、1个月及2个月,观察组的总主动活动度(TAM)评分均显著高于对照组(均P<0.05)。两组患者严重色素沉着率比较,差异无统计学意义(P>0.05)。结论前臂游离动脉化静脉皮瓣修复手部软组织缺损的效果显著,术后手功能恢复良好,且不良反应发生率低。Objective To explore the application effect of forearm free arterialized venous flaps in repairing soft tissue defect of the hand.Methods Ninety patients with hand soft tissue defect were selected as observed subjects,of which 45 cases(control group)received distal forearm palmar arterialized venous flaps,while the other 45 cases(observation group)received forearm free arterialized venous flaps.The clinical effect was compared between the two groups.Results In comparison with the control group,the observation group yielded higher flap survival rate(97.78%vs.82.22%)and skin recovery rate(95.56%vs.82.22%),whereas shorter healing duration and smaller two points of flap tactile discrimination,as well as a lower incidence of adverse reactions(4.44%vs.13.33%,all P<0.05).The scores of total active motion(TAM)at time of 1 week,1 month and 2 months after operation were significantly higher in the observation group than in the control group(all P<0.05).There was no statistically significant difference in severe pigmentation rate between the two groups(P>0.05).Conclusion Forearm free arterialized venous flaps has a significant effect in repairing hand soft tissue defect,with a good functional recovery of hand and a low incidence of adverse reactions after operation.

关 键 词：前臂游离皮瓣 软组织缺损 修复 不良反应 

分 类 号：R658.2[医药卫生—外科学]