指固有动脉顺行与逆行岛状皮瓣修复手指软组织缺损的疗效比较  

Comparison of the Efficacy of Anterograde and Retrograde Island Flaps of the Proper Digital Artery in the Repair of Soft Tissue Defects of the Finger

作　　者：石娜 崔彦明 梁盾 SHI Na;CUI Yan-ming;LIANG Dun(Department of Orthopedic Surgery,the Third People's Hospital of Yangquan City,Yangquan,Shanxi 045000,China;Department of Orthopedics,the First People's Hospital of Yangquan City,Yangquan,Shanxi 045000,China)

机构地区：[1]阳泉市第三人民医院手外足踝整形外科,山西阳泉045000 [2]阳泉市第一人民医院骨科,山西阳泉045000

出　　处：《临床误诊误治》2023年第1期81-85,共5页Clinical Misdiagnosis & Mistherapy

基　　金：山西省自然科学基金项目(210816MH303)。

摘　　要：目的探讨指固有动脉顺行与逆行岛状皮瓣修复手指软组织缺损的疗效。方法回顾性分析2018年1月—2021年3月收治的手指软组织缺损350例,按方法分为逆行组和顺行组,各175例。逆行组给予指固有动脉逆行岛状皮瓣修复治疗,顺行组给予指固有动脉顺行岛状皮瓣修复治疗。术后均随访1年。比较2组临床疗效,手术前后指间关节活动度及密歇根手部功能量表评分,手术相关指标。结果随访1年,顺行组感觉功能优良率高于逆行组,两点辨别觉短于逆行组(P<0.01)。顺行组手术时间及住院时间短于逆行组,术中出血量少于逆行组(P<0.05)。随访期间,2组感染率比较差异无统计学意义(P>0.05)。出院时和术后6个月,2组伤侧近指间关节(PIP)及远指间关节(DIP)活动度均大于术前,且术后6个月大于出院时(P<0.05);出院时,顺行组伤侧PIP及DIP活动度大于逆行组,但术后6个月小于逆行组(P<0.01)。随访1年后,2组日常活动能力、全手总体功能、工作能力、疼痛、外观及手部功能满意度评分均较术前升高(P<0.05)。结论相比于指固有动脉逆行岛状皮瓣修复,指固有动脉顺行岛状皮瓣修复在缩短手术时间、住院时间及减少术中出血量方面具有较大优势,且可有效促进手指软组织缺损患者手指感觉的恢复,但对指间关节活动度恢复具有一定影响,安全性良好。Objective To investigate the efficacy of anterograde and retrograde island flaps of the proper digital artery in repairing soft tissue defects of fingers.Methods A retrospective analysis was performed on 350 patients with soft tissue defects of the finger treated from January 2018 to March 2021,and they were divided into the retrograde group(n=175)and the anterograde group(n=175).The retrograde group was given the retrograde island flap of the proper digital artery,and the anterograde group was given the retrograde island flap of the proper digital artery.All patients were followed up for 1 year.The clinical efficacy,range of motion(ROM)of interphalangeal joint before and after surgery,Michigan Hand Function Scale score,and operation-related indexes were compared between the two groups.Results At 1 year after follow-up,the excellent and good rate of superior sensory function in the anterograde group was higher than that in the retrograde group,and the two-point discernment was shorter than that in the retrograde group(P<0.01).The duration of operation and the length of hospital stay in the anterograde group were shorter than those in the retrograde group,and the intraoperative blood loss was less than that in the retrograde group(P<0.05).During the follow-up period,there was no significant difference in infection rate between the two groups(P>0.05).At discharge and 6 months after surgery,the ROM of proximal interphalangeal joint(PIP)and distal interphalangeal joint(DIP)on the injured side of the two groups was greater than that before surgery,and greater at 6 months after surgery than that at discharge(P<0.05).At the time of discharge,the ROM of PIP and DIP in the anterograde group was higher than that in the retrograde group,but lower than that in the retrograde group at 6 months after surgery(P<0.01).At 1 year after follow-up,the satisfaction scores of activities of daily life,total hand function,working ability,pain,appearance and hand function in both groups were higher than those before surgery(P<0.05).Concl

关 键 词：手指软组织缺损 指固有动脉逆行岛状皮瓣修复 指固有动脉顺行岛状皮瓣修复 指间关节活动度 密歇根手部功能量表评分 

分 类 号：R628[医药卫生—整形外科]