Flow-through前臂掌侧静脉皮瓣在复杂拇指离断伤再植中的应用  

Application of Flow-through forearm palmar venous flap in replantation of complex amputated thumb

作　　者：王象征 周海洋[2] Wang Xiangzheng;Zhou Haiyang(Department of Emergency,Nanjing Integrated Traditional Chinese and Western Medicine Hospital Affiliated to Nanjing University of Chinese Medicine,Jiangsu Nanjing 210017,China;Department of Orthopedics,Nanjing Integrated Traditional Chinese and Western Medicine Hospital Affiliated to Nanjing University of Chinese Medicine,Jiangsu Nanjing 210017,China)

机构地区：[1]南京中医药大学附属南京市中西医结合医院急诊科,江苏南京210017 [2]南京中医药大学附属南京市中西医结合医院骨科,江苏南京210017

出　　处：《中国医刊》2021年第7期745-747,共3页Chinese Journal of Medicine

基　　金：南京市科技计划项目(201605057)。

摘　　要：目的探讨Flow-through前臂掌侧静脉皮瓣应用于复杂拇指离断伤再植的临床效果及术后手功能恢复情况。方法选取2015年1月至2019年6月南京中医药大学附属南京市中西医结合医院收治的复杂拇指离断伤患者80例,采用随机数字表法分为对照组与研究组,每组40例。对照组患者接受侧方皮瓣修复,研究组患者行Flow-through前臂静脉皮瓣修复,术后随访12个月,比较两组患者的手功能恢复、严重不良反应及远期预后(皮肤颜色加深及弹性较差)情况。结果术后12个月时,研究组患者手功能优良率(92.5%)明显高于对照组(75.0%),差异有显著性(P<0.05)。研究组术后静脉危象及皮瓣坏死等严重不良反应发生率(5.0%)明显低于对照组(22.5%),差异有显著性(P<0.05)。术后12个月时研究组皮肤颜色加深及弹性较差的发生率(7.5%)明显低于对照组(50.0%),差异有显著性(P<0.05)。结论Flow-through前臂掌侧静脉皮瓣应用于复杂拇指离断伤再植疗效确切,且可明显降低不良反应发生率,值得临床应用。Objective To explore the curative effect and functional recovery of Flow-through forearm palmar venous flap in patients with complex amputated thumb.Method Eighty patients with complex amputated thumb injury treated in our hospital from January 2017 to June 2019 were randomly divided into control group(n=40)and study group(n=40).The patients in the control group were repaired with lateral skin flap and the patients in the study group were repaired with Flow-through venous flap.The patients were followed up for 12 months.The recovery of hand function was compared between the two groups.Result The excellent and good rate of hand function recovery in the study group was significantly higher than that in the control group,and there was significant difference between the two groups(P<0.05).During the follow-up,there was a significant difference in the incidence of venous crisis and flap necrosis between the two groups,and the incidence of venous crisis and flap necrosis in the study group was lower than that in the control group(P<0.05).The incidence of color deepening and elastic deterioration in the study group was significantly lower than that in the control group,and the difference was statistically significant(P<0.05).Conclusion Flow-through forearm palmar vein flap is effective in replantation of complex amputated thumb and can significantly reduce the incidence of adverse reactions in patients.Therefore,it is suggested that Flow-through forearm palmar vein flap should be used to treat complex amputated thumb replantation according to the actual condition.

关 键 词：前臂掌侧静脉皮瓣 复杂拇指离断伤 再植 手功能 

分 类 号：R658.1[医药卫生—外科学]