指端皮肤缺损患者应用不同神经处理方法的第二趾胫侧皮瓣修复的临床效果  

Effects of different neural processing methods for repair of tibial flap of the second toe in patients with fingertip skin defect

作　　者：侯训凯 石恩东 冀少林 赵立宁 王建伟 HOU Xun-kai;SHI En-dong;JI Shao-lin;ZHAO Li-ning;WANG Jian-wei(Trauma and Hand and Foot Surgery,Shandong Provincial Third Hospital,Jinan 250031,Shandong,China)

机构地区：[1]山东省立第三医院创伤与手足外科,山东济南250031

出　　处：《川北医学院学报》2022年第9期1143-1147,共5页Journal of North Sichuan Medical College

基　　金：山东省2022年基层卫生科技创新计划项目(JCK22004)。

摘　　要：目的:探究指端皮肤缺损患者应用不同神经处理方法的第二趾胫侧皮瓣修复的效果。方法:回顾性分析82例行第二趾胫侧皮瓣修复的指端皮肤缺损患者的临床资料,按照不同神经处理方法分为趾底组和趾背组。比较两组围术期指标、疼痛程度[视觉模拟评分(VAS)]、治疗效果、恢复情况、感觉恢复情况、两点辨别觉等。结果:两组手术时间、住院时间比较,差异无统计学意义(P>0.05);术后3 d、7 d静息和活动状态,两组VAS评分均无统计学差异(P>0.05);术后1个月,趾底组触觉、痛觉、冷觉和热觉恢复比例高于趾背组(P<0.05);术后3个月,趾底组两点辨别觉高于趾背组(P<0.05)。术后3个月,两组治疗优良率、皮瓣功能、皮瓣瘢痕、关节总活动度比较,差异无统计学意义(P>0.05);结论:带趾底固有神经与带趾背神经处理方法在指端皮肤缺损患者中的疗效均较好,但带趾背神经的患者受区和供区感觉恢复情况更好。Objective:To explore the effects of repair of tibial flap of the second toe with different neural processing methods in patients with fingertip skin defect.Methods:A retrospective analysis was performed on the clinical data of 82 patients with fingertip skin defect who underwent the second toe tibial flap repair in the hospital.The patients were divided into the plantar digital group and the dorsal digital group according to different nerve treatment methods.The perioperative indicators,pain degree[Visual Analogue Scale(VAS)],treatment effects,recovery status,sensory recovery and two-point discrimination were compared.Results:There were no significant differences in the surgical time and hospital stay between the two groups(P>0.05).There were no significant differences in the VAS scores in resting state and activity state at 3 and 7 d after surgery between the two groups(P>0.05).At 1 month after surgery,the recovery ratios of touch,pain sensation,cold sensation and heat sensation in the plantar digital group were significantly higher compared with those in the dorsal digital group(P<0.05).At 3 months after surgery,the two-point discrimination values were higher in the plantar digital group than those in the dorsal digital group(P<0.05).3 months after operation,there was no significant difference between the two groups in the the excellent and good rate of treatment,skin flap function,skin flap scar and total joint range of motion(P>0.05).Conclusion:Proper plantar digital nerve and dorsal digital nerve processing methods both have good efficacy in the repair of tibial flap of the second toe in patients with fingertip skin defect,but the sensory recovery status of the recipient site and donor site are better in patients with dorsal digital nerve.

关 键 词：指端皮肤缺损 趾底固有神经 趾背神经 皮瓣修复 临床效果 

分 类 号：R622.3[医药卫生—整形外科]