游离桡动脉掌浅支皮瓣修复手指末节指腹缺损疗效研究  

Clinical curative effect of the free radial artery superficial palmar branch flap repair on distal finger pulp defects

作　　者：蒋美超[1] 胡长青[1] 连勇[1] 丁思广[1] 张羽[1] 王保申[2] 郝志伟[3] JIANG Meichao;HU Changqing;LIAN Yong;DING Siguang;ZHANG Yu;WANG Baoshen;HAO Zhiwei(The Fifth Department of Orthopedics,Baoding No.l Central Hospital,Baoding 071000,China;Department of Cardiovascular Surgery,Baoding No.1 Central Hospital,Baoding 071000,China;The Second Department of General Surgery,Baoding No.l Central Hospital,Baoding 071000,China)

机构地区：[1]保定市第一中心医院骨5科,河北保走071000 [2]保定市第一中心医院心血管外科,河北保定071000 [3]保定市第一中心医院普外2科,河北保定071000

出　　处：《长春中医药大学学报》2022年第6期667-670,共4页Journal of Changchun University of Chinese Medicine

基　　金：2021年保定市科技计划自筹经费项目第一批(2141ZF062)。

摘　　要：目的探讨游离桡动脉掌浅支皮瓣修复手指末节指腹缺损的临床疗效。方法选取手指末节指腹缺损患者64例,根据随机数表法分为观察组与对照组,各32例,对照组予指背岛状皮瓣修复治疗,观察组予游离桡动脉掌浅支皮瓣修复治疗,观察2组治疗后围手术期指标、手指外观、皮瓣成活率、近远侧指间关节活动度和手指感觉恢复状况。结果观察组血液循环评分(7.54±1.64)分,明显高于对照组的(6.37±1.05)分(P<0.05)。观察组手术后皮瓣成活率(93.75%,30/32)明显高于对照组(75.00%,24/32)(P<0.05);观察组近侧指间关节活动度、远侧指间关节活动度分别为(107.41±16.95)℃、(71.84±9.57)℃,明显高于对照组的(94.16±14.32)℃、(59.64±7.35)℃(均P<0.05);观察组手指感觉恢复明显优于对照组(P<0.05);观察组手指外观评分(18.52±3.20)分,高于对照组的(16.14±2.88)分(P<0.05)。结论应用游离桡动脉掌浅支皮瓣修复治疗手指末节指腹缺损疗效显著,可提高皮瓣成活率、血流循环、近远侧指间关节活动度,促进手指功能恢复,改善手指外观。Objective To explore the clinical curative effect of the free radial artery superficial palmar branch flap repair on distal finger pulp defects.Methods A total of 64 patients with distal finger pulp defects were enrolled as the study subjects and divided into an observation group and a control group according to the random number table method,with 32 cases in each group.The control group was treated with the dorsal finger island flap repair,while the observation group was treated with the free radial artery superficial palmar branch flap repair.The perioperative indexes,finger appearance,flap survival rate,distal and proximal interphalangeal joint range of motion,and recovery of finger sensation were observed in the two groups after treatment.Results The score of blood circulation in the observation group was significantly higher than that in the control group[(7.54±1.64)points vs.(6.37+1.05)points](P<0.05).After surger%the flap survival rate in the observation group was significantly higher than that in the control group[93.75%(30/32)vs.75.00%(24/32)](P<0.05).The proximal and distal interphalangeal joint range of motion values in the observation group were(107.41±16.95)℃ and(71.84±9.57)℃,significantly higher than those in the control group[(94.16±14.32)℃,(59.64±7.35)℃](P<0.05).The recovery of finger sensation in the observation group was significantly better than that in the control group(P<0.05),and the score of finger appearance was higher than that in the control group[(18.52±3.20)points vs(16.14±2.88)points](P<0.05).Conclusion The curative effect of the free radial artery superficial palmar branch flap repair is significant on distal finger pulp defects,which can improve the flap survival rate,blood circulation,proximal and distal interphalangeal joint range of motion,promote the recovery of finger function and improve the finger appearance.

关 键 词：手指末节指腹缺损 桡动脉掌浅支 皮瓣修复 皮瓣成活率 指间关节活动度 

分 类 号：R658.2[医药卫生—外科学]