游离股前外侧皮瓣修复手部软组织缺损的疗效及皮瓣存活因素的分析  

Effects of free anterolateral femoral flap in repairing soft tissue defect of hand and analysis of flap survival factors

作　　者：蔡灵敏 郭翱[1] 郑良军[1] 欧阳代明 CAI Lingming;GUO Ao;ZHENG Liangjun;OUYANG Daiming(Department of Hand surgery,Taizhou Orthopedics Hospital,Taizhou 317500,China)

机构地区：[1]台州骨伤医院手外科,浙江台州317500

出　　处：《健康研究》2021年第1期91-94,共4页Health Research

摘　　要：目的探讨游离股前外侧皮瓣修复手部软组织缺损的临床效果,并分析影响游离皮瓣存活的相关因素。方法100例手部软组织缺损患者,均在彻底清创处理后行游离股前外侧皮瓣移植术修复。评价患者创面愈合的情况,并搜集患者的临床资料,采用卡方检验和Logistic回归分析模型对影响皮瓣存活的相关因素进行分析。结果经游离股前外侧皮瓣移植修复后,皮瓣移植存活率为81%。单因素分析结果显示皮瓣坏死与患者的年龄、吸烟、患糖尿病、皮瓣受区感染、精神状态和NRS疼痛评分有关(P<0.05),多因素Logistic回归分析结果显示年龄>60岁、吸烟、患糖尿病、皮瓣受区感染、精神状态差、NRS疼痛评分>7分是皮瓣坏死的独立危险因素(P<0.05)。结论游离股前外侧皮瓣移植修复手部软组织缺损的皮瓣存活率较高,年龄>60岁、吸烟、糖尿病、皮瓣受区感染、精神状态差、NRS疼痛评分>7分是皮瓣坏死的危险因素。Objective To investigate the clinical outcomes of the free anterolateral femoral flap in repairing the soft-tissue defects in the hand and to analyze the factors associated with the survival of the free flap.Methods A total of 100 patients with soft-tissue defects of the hand received free anterolateral femoral flap transplantation after thorough debridement.The process of wound healing was evaluated and relevant clinical data were collected.The Chi-square tests and Logistic regression analysis models were used to analyze the factors associated with flap survival.Results After the free anterolateral femoral flap transplantation,the flap transplantation survival rate was 81%.Univariate analysis showed that skin flap necrosis was related to age,smoking,diabetes,skin flap infection,mental status,and NRS pain score(P<0.05).Multivariate Logistic regression analysis showed that aged over 60,smoking,diabetes,skin flap infection,bad mental status,and NRS pain scored>7 were independent risk factors for skin flap necrosis(P<0.05).Conclusions Free anterolateral thigh flap transplantation to repair the hand soft-tissue defect has a higher survival rate.Aged over 60 years old,smoking,diabetes,flap area infection,bad mental status,NRS pain score>7 points were risk factors for flap necrosis.

关 键 词：游离股前外侧皮瓣 软组织缺损 移植 皮瓣存活 影响因素 

分 类 号：R658.3[医药卫生—外科学]