两种岛状皮瓣修复手指软组织缺损的疗效比较  

Efficacy comparison of two kinds of island flaps in repairing finger soft tissue defects

作　　者：向湘华 庄智勇 蔡金表 郭超龙 郭传存 XIANG Xiang-hua;ZHUANG Zhi-yong;CAI Jin-biao;GUO Chao-long;GUO Chuan-cun(Dept of Hand Surgery,Quanzhou Orthopaedic-Traumatological Hospital of Fujian TCM University,Quanzhou,Fujian 362000,China)

机构地区：[1]福建中医药大学附属泉州市正骨医院手外科,福建泉州362000

出　　处：《临床骨科杂志》2021年第4期515-518,共4页Journal of Clinical Orthopaedics

摘　　要：目的比较指固有动脉顺行、逆行岛状皮瓣修复手指软组织缺损的临床疗效。方法将42例手指软组织缺损患者按治疗方法不同分为两组,分别采用指固有动脉顺行岛状皮瓣修复(顺行组,20例)、指固有动脉逆行岛状皮瓣修复(逆行组,22例)。比较两组手术情况、术后并发症、住院时间、手指感觉功能及运动功能优良率。结果患者均获得随访,时间6~58个月。两组皮瓣均成活。手术时间、术中出血量、住院时间、末次随访时手指感觉功能优良率顺行组均优于逆行组(P <0.01)。末次随访时手指运动功能优良率顺行组优于逆行组,但差异无统计学意义(P> 0.05)。顺行组患指术后未出现供血不足、回流异常等并发症,外观更美观;逆行组出现6例并发症;术后并发症发生率顺行组低于逆行组(P <0.05)。结论指固有动脉逆行、顺行岛状皮瓣修复手指软组织缺损均能较好恢复运动功能,但顺行岛状皮瓣手术难度小,耗时少,出血量少,术后皮瓣供血及回流好,住院时间短,患者感觉功能恢复佳,患指外观满意。Objective To compare the clinical efficacy of antegrade or retrograde island flap of proper digital artery in repairing finger soft tissue defects. Methods The 42 patients with finger soft tissue defects were divided into two groups,according to the treatment method,one group was repaired with antegrade digital artery island flap( antegrade group,20 cases),the other group was repaired with retrograde digital artery island flap( retrograde group,22 cases).The intraoperative conditions,postoperative complications,length of hospital stay,the excellent-good rate of finger sensory function and finger motor function were compared between the two groups. Results All patients were followed up for 6 ~ 58 months. Both groups of flaps survived. The operation time,intraoperative blood loss,length of hospital stay and excellent-good rate of finger sensory function at the last follow-up in antegrade group were better than those in retrograde group( P < 0. 01). At the last follow-up,the excellent-good rate of finger motor function in antegrade group was better than that in retrograde group,while the difference was not statistically significant( P > 0. 05). There were no complications such as insufficient blood supply and abnormal reflux after operation in the antegrade group,with more beautiful appearance;and there were 6 cases of complications in the retrograde group;the complication incidence rate of angegrade group was lower than that of the retrograde group( P < 0. 05). Conclusions Antegrade and retrograde island flap of proper digital artery can restore good motor function in repairing finger soft tissue defects,but antegrade island flap has less difficulty,less time consumption,less blood loss,with good blood supply and reflux of flap after operation,short length of hostpital stay,good sensation recovery and satisfactory appearance.

关 键 词：顺行岛状皮瓣 逆行岛状皮瓣 手指软组织缺损 指固有动脉 创面修复 

分 类 号：R622.1[医药卫生—整形外科] R658.2[医药卫生—外科学]