拇指背侧皮神经营养血管皮瓣修复联合康复训练对拇指远端软组织缺损的应用探究  

The Application of Thumb Dorsal Cutaneous Neurotrophic Vascular Flap Repair Combined with Rehabilitation Training in Soft Tissue Defect of Distal Thumb

作　　者：安晓飞 常红 王辉 An Xiaofei;Chang Hong;Wang Hui(Department of Orthopedics,Tangshan Second Hospital,Tangshan,Hebei 063000,China)

机构地区：[1]唐山第二医院骨科,河北唐山063000

出　　处：《四川医学》2022年第2期113-118,共6页Sichuan Medical Journal

基　　金：河北省高层次人才资助项目(编号:A201901124)。

摘　　要：目的探讨拇指背侧皮神经营养血管皮瓣修复联合康复训练治疗拇指远端软组织缺损的效果。方法选取我院2019年8月至2020年11月收治的68例拇指远端软组织缺损患者,随机分为两组,观察组34例,实施拇指背侧皮神经营养血管皮瓣修复,对照组34例,实施腹部皮瓣修复。观察并记录两组患者皮瓣感觉指标、皮瓣外观、瘢痕挛缩及DASH评分、不良反应发生率然后进行统计分析。结果两组患者触觉、温度觉、压觉和两点辨别觉相比,观察组优于对照组,差异有统计学意义(P<0.05);两组患者皮瓣外观臃肿发生率相比,观察组低于对照组,差异有统计学意义(P<0.05),但两组瘢痕挛缩相比差异无统计意义(P>0.05);观察组DASH评分低于对照组,差异有统计学意义(P<0.05);观察组不良反应发生率均明显低于对照组,差异有统计学意义(P<0.05)。结论采用拇指背侧皮神经营养血管皮瓣修复联合康复训练治疗拇指远端软组织缺损,能够有效保护患者主要血管神经,不仅修复皮瓣外观、感觉功能较好,而且操作简便、对皮瓣供区影响小,值得临床推广。Objective To explore the effect of repairing the soft tissue defect of distal thumb with dorsal cutaneous neurovascular flap and rehabilitation training.Methods Sixty-eight patients with distal soft tissue defects of the thumb admitted to our hospital from August 2019 to November 2020 were selected as subjects.They were randomly divided into two groups.34 patients in the observation group were treated with the dorsal cutaneous neurocutaneous flap of the thumb, and 34 patients in the control group were treated with abdominal flap.The flap sensory index, flap appearance, scar contracture and DASH score were observed and recorded in the two groups, and then statistical analysis was performed.Results There were statistically significant differences in tactile, temperature sensation, pressure sensation and two-point discrimination between the two groups(P<0.05).There was a statistically significant difference in the incidence of edema between the two groups(P<0.05).There was no statistically significant difference between the two groups(P>0.05).There was also a statistically significant difference in DASH score between the two groups(P<0.05).Conclusion The dorsal cutaneous neurovascular flap of thumb combined with rehabilitation training can effectively protect the main blood vessels and nerves in the soft tissue defects of the distal thumb.It is not only good in repairing the appearance and sensory function of the flap, but also simple in operation and has little impact on the flap supply area, which is worth clinical promotion.

关 键 词：拇指远端软组织缺损 腹部皮瓣 皮瓣修复 康复训练 

分 类 号：R658.2[医药卫生—外科学]