原位缝合联合去表皮包埋法治疗指端撕脱离断血管毁损患者的效果分析  

Efficacy of in situ suture combined with de-epithelialized abdomen embedding in the treatment of finger avulsion injury with vascular damage

作　　者：倪少俊 徐秋月 王成 NI Shaojun;XU Qiuyue;WANG Cheng(Department of Plastic and Burn Surgery,The Fifth Affiliated Hospital of Zunyi Medical Uni-versity,Zhuhai 519100,China)

机构地区：[1]遵义医科大学第五附属(珠海)医院整形烧伤手外科,广东珠海519100 [2]遵义医科大学第五附属(珠海)医院手术室,广东珠海519100

出　　处：《中国美容整形外科杂志》2022年第7期398-400,420,共4页Chinese Journal of Aesthetic and Plastic Surgery

摘　　要：目的 分析原位缝合联合去表皮包埋法治疗指端撕脱离断血管毁损患者的效果。方法 自2019年1月至2020年12月,遵义医科大学第五附属(珠海)医院整形烧伤手外科治疗62例指端撕脱离断血管毁损患者。根据治疗方案不同将其分为对照组和研究组,31例/组。对照组采用腹壁皮下分期包埋法,研究组采用原位缝合联合去表皮包埋法。在术前及术后评价两组患者疼痛及关节总主动活动度、握力;在术后评定两组患者临床疗效、二次手术及并发症发生率。结果 术前两组患者疼痛及关节总主动活动度差异无统计学意义(P>0.05)。术后8周研究组患者疼痛VAS评分低于对照组(P<0.05),关节总主动活动度高于对照组(P<0.05)。在术前两组患者握力差异无统计学意义(P>0.05)。术后8周研究组患者握力大于对照组(P<0.05)。研究组患者临床总有效率高于对照组(P<0.05)。研究组患者二次手术及并发症发生率低于对照组(P<0.05)。结论 原位缝合联合去表皮包埋法治疗指端撕脱离断血管毁损能明显改善患者疼痛、功能和握力,提高临床疗效,减少并发症的发生率。Objective To analyze the efficacy of in situ suture combined with de-epithelialized abdomen embedding in the treatment of finger avulsion injury with vascular damage. Methods From January 2019 to December 2020, 62 patients with finger avulsion injury and vascular damage were selected. All patients were divided into control group and study group according to different treatment methods, with 31 cases in each group. The subperitoneal embedding was performed in the control group, and in situ suture combined with de-epithelialized abdomen embedding was performed in the study group. The pain, active range of motion and grip strength were assessed before and after surgery. The clinical efficacy, reoperation rate and complications between 2 groups were compared. Results There was no significant difference in pain and active range of motion between 2 groups before surgery(P>0.05). At 8 weeks after surgery, the VAS score of pain in the study group was lower than that in the control group(P<0.05), and the active range of motion was higher than that in the control group(P<0.05). There was no significant difference in grip strength between 2 groups(P>0.05) before surgery. At 8 weeks after surgery,the grip strength and clinical effectiveness in the study group was higher than that in the control group(P<0.05). Compared with the control group, the rate of reoperation and complications was low in the study group(P<0.05). Conclusion Application of in situ suture combined with de-epithelialized abdomen embedding in the treatment of finger avulsion injury with vascular damage can effectively alleviate pain,active range of motion and grip strength and reduce complication rate.

关 键 词：原位缝合 去表皮包埋法 指端撕脱离断血管毁损 效果 二次手术 

分 类 号：R658.2[医药卫生—外科学]