尺动脉腕上皮支游离皮瓣和桡动脉腕上皮支游离皮瓣在修复手部软组织缺损中的效果比较  

Comparison of the effects of ulnar artery carpal epithelial branch free flap and radial artery carpal epithelial branch free flap in repairing soft tissue defect of hand

作　　者：曲开 李哲 韩动 王洪一 陶凯 Qu Kai;Li Zhe;Han Dong;Wang Hongyi;Tao Kai(Department of Burn and Plastic Surgery,General Hospital of Northern Theater Command,Shenyang 110016,China)

机构地区：[1]北部战区总医院烧伤整形科,沈阳110016

出　　处：《中国临床实用医学》2021年第4期11-15,共5页China Clinical Practical Medicine

基　　金：国家自然基金青年基金(82002047)。

摘　　要：目的比较尺动脉腕上皮支游离皮瓣和桡动脉腕上皮支游离皮瓣在修复手部软组织缺损治疗中的效果。方法选取2015年1月至2019年1月北部战区总医院烧伤整形科收治的16例手部软组织缺损患者,男13例,女3例,年龄(39.76±8.88)岁,年龄范围为21~56岁。根据选择皮瓣的不同分为尺动脉组(n=6)和桡动脉组(n=10)。分别采用尺动脉腕上皮支游离皮瓣和桡动脉腕上皮支游离皮瓣修复。术后对所有患者随访6个月以上,密切观察皮瓣的成活率、色泽、温度、毛细血管充盈反应和皮瓣的感觉恢复情况。统计受区并发症情况,对术后手部功能、感觉功能及手部外观进行评估。结果所有患者的创面均修复成功,尺动脉腕上皮支游离皮瓣厚度较厚,部分患者存在汗毛生长。尺动脉组中,1例患者术后第1天出现远端皮瓣青紫现象,术后3 d恢复正常。桡动脉组供区静态两点辨别觉(S-2PD)方法[(9.09±0.38)mm]及受区S-2PD[(8.77±0.39)mm]、客观外观评分[(92.42±2.90)分]和主观外观评分[(86.45±1.11)分]均优于尺动脉组[(7.78±0.43)mm、(7.05±0.61)mm、(84.30±1.14)分、(82.06±0.69)分],差异有统计学意义(P<0.05)。结论尺动脉腕上皮支游离皮瓣和桡动脉腕上皮支游离皮瓣均可用于修复手部软组织损伤,其中桡动脉腕上皮支游离皮瓣效果更佳,值得临床推广。Objective To compare the effects of ulnar artery carpal epithelial branch free flap and radial artery carpal epithelial branch free flap in repairing soft tissue defects of hands.Methods A total of 16 patients with soft tissue defect of hands were selected from January 2015 to January 2019 in the Burn Orthopedics department of The General Hospital of the Northern Theater Command,13 males and 3 females,aged(39.76±8.88)years old,ranging from 21 to 56 years old.According to different flaps,they were divided into ulnar artery group(n=6)and radial artery group(n=10).The radial and ulnar artery supercarpal perforator flaps were used for repair.All patients were followed up for more than 6 months,and the survival rate,color,temperature,capillary filling reaction and sensory recovery of the flap were closely observed.Complications were counted,and postoperative hand function,sensory function and hand appearance were evaluated.Results The wounds of all patients were successfully repaired,the ulnar artery perforator flap was thick,and some patients had hair growth.In the ulnar artery group,the distal flap was bluish in one patient on the first postoperative day,and returned to normal on the third postoperative day.The static 2-point discrimination(S-2PD)of the radial artery group donor area radial artery group[(9.09±0.38)mm]and the S-2PD of the radial artery group recipient area[(8.7±0.39)mm],objective appearance score[(92.42±2.90)points]and subjective ratings appearance[(86.45±1.11)points]group were superior to ulnar arteries[(7.78±0.43)mm,(7.05±0.61)mm,(84.30±1.14)points,(82.06±0.69)points],the difference was statistically significant(P<0.05).Conclusion Both ulnar artery carpal epithelial branch free flap and radial artery carpal epithelial branch free flap can be used to repair the soft tissue defect of hand,and the radial artery carpal epithelial branch free flap is more effective and worthy of clinical promotion.

关 键 词：尺动脉腕上皮支游离皮瓣 桡动脉腕上皮支游离皮瓣 皮瓣 游离皮瓣 软组织缺损 创面修复 

分 类 号：R658.2[医药卫生—外科学]