穿支皮瓣与游离皮瓣修复手部及前臂皮肤缺损的疗效对比  

Comparison of Perforator Flap Repair and Free Flap Repair for Skin Defects in Hands and Forearms

作　　者：肖军波 李丽[1] 王宏平 许明刚 李程科 XIAO Jun-bo;LI Li;WANG Hong-ping;XU Ming-gang;LI Cheng-ke(Department of Hand-foot Microsurgery,Jinan University Attached Shunde Hospital,Foshan 528305,China)

机构地区：[1]暨南大学附属顺德医院手足显微外科,广东佛山528305

出　　处：《实用临床医学（江西）》2020年第7期13-16,共4页Practical Clinical Medicine

基　　金：佛山市科学技术局项目(佛科[2018]206号)。

摘　　要：目的对比手部及前臂皮肤缺损治疗中穿支皮瓣修复与游离皮瓣修复的临床疗效及并发症发生率。方法选取46例手部及前臂皮肤缺损患者,按随机数字表法分为试验组和对照组(每组23例),试验组给予穿支皮瓣修复,对照组给予游离皮瓣修复,对比2组修复治疗效果(修复总有效率)、血清炎症因子[白细胞介素-8(IL-8)、肿瘤坏死因子-α(TNF-α)和白细胞介素-6(IL-6)]、并发症(皮瓣坏死、脂肪液化和感染)发生率和创面愈合时间。结果试验组修复总有效率明显高于对照组(95.65%比56.52%,P<0.01),术后7 d血清TNF-α、IL-8和IL-6水平均明显低于对照组(均P<0.001),并发症发生率明显低于对照组(4.35%比30.43%,P<0.05),创面愈合时间显著短于对照组(P<0.001)。结论穿支皮瓣修复可有效改善手部及前臂皮肤缺损患者手功能,减轻炎症反应,降低感染等并发症发生率,促进创面愈合。Objective To compare the clinical efficacy and complications of perforator flap repair and free flap repair in the treatment of skin defects in hands and forearms.Methods Forty-six patients with skin defects in hands and forearms were randomly assigned to receive either perforator flap repair(experimental group,n=23)and free flap repair(control group,n=23).The total effective rate,serum interleukin-8(IL-8),tumor necrosis factor-α(TNF-α)and interleukin-6(IL-6)levels,incidence of complications(flap necrosis,fat liquefaction and infection),and wound healing time were compared between the two groups.Results The total effective rate in experimental group(95.65%)was higher than that in control group(56.52%)(P<0.01).Serum levels of TNF-α,IL-8 and IL-6 in experimental group were lower than those in control group 7 days after operation(P<0.001).The incidence of complications in experimental group(4.35%)was lower than that in control group(30.43%)(P<0.05).The wound healing time in experimental group was shorter than that in control group(P<0.001).Conclusion Perforator flap repair can effectively improve hand function,alleviate inflammation,reduce infection and other complications,and promote wound healing in patients with skin defects in the hands and forearms.

关 键 词：手部 前臂 皮肤缺损 穿支皮瓣修复 游离皮瓣修复 临床疗效 感染 

分 类 号：R658.2[医药卫生—外科学]