局部不规则转移皮瓣术治疗骶尾部藏毛窦的效果及对创伤应激反应、创面愈合情况的影响  

Effect of local irregular transfer flap in the treatment of sacrococcygeal pilonidal sinus and its influences on traumatic stress response and wound healing

作　　者：严昌林 焦英伟 孙金龙 YAN Changlin;JIAO Yingwei;SUN Jinlong(Affiliated Hospital of Shaanxi University of Chinese Medicine,Xianyang 712000;No.215 Hospital of Shaanxi Nuclear Industry,Xianyang 712000,China)

机构地区：[1]陕西中医药大学附属医院,陕西咸阳712000 [2]陕西省核工业二一五医院,陕西咸阳712000

出　　处：《临床医学研究与实践》2023年第34期61-64,共4页Clinical Research and Practice

基　　金：陕西省核工业二一五医院科研立项。

摘　　要：目的探讨局部不规则转移皮瓣术治疗骶尾部藏毛窦的效果及对创伤应激反应、创面愈合情况的影响。方法选取2019年1月至2022年1月收治的80例骶尾部藏毛窦患者为研究对象,按照随机数字表法将其分为对照组和观察组,各40例。对照组实施菱形转移皮瓣术,观察组实施局部不规则转移皮瓣术。比较两组的治疗效果。结果观察组的治疗总有效率高于对照组(P<0.05)。术后1 d,观察组的皮质醇(Cor)、肾上腺素(E)、C-反应蛋白(CRP)水平低于对照组(P<0.05)。术后1 d,观察组的血管内皮生长因子(VEGF)、碱性成纤维细胞生长因子(bFGF)、表皮生长因子(EGF)水平高于对照组(P<0.05)。术后1周,观察组的创面肉芽生长评分高于对照组,视觉模拟评分法(VAS)评分低于对照组(P<0.05);术后4周,两组的创面肉芽生长评分、VAS评分无明显差异(P>0.05);观察组的创面愈合时间短于对照组(P<0.05)。结论局部不规则转移皮瓣术治疗骶尾部藏毛窦患者效果显著,可以减轻机体创伤应激反应,调节生长因子水平,促进创面快速愈合,值得推广。Objective To investigate the effect of local irregular transfer flap in the treatment of sacrococcygeal pilonidal sinus and its influences on traumatic stress response and wound healing.Methods A total of 80 patients with sacrococcygeal pilonidal sinus admitted from January 2019 to January 2022 were selected as the research objects and divided into control group and observation group according to the random number table method,with 40 cases in each group.The control group was treated with diamond transfer flap,and the observation group was treated with local irregular transfer flap.The treatment effects of the two groups were compared.Results The total effective rate of treatment in the observation group was higher than that in the control group(P<0.05).At 1 d after operation,the levels of cortisol(Cor),epinephrine(E)and C-reactive protein(CRP)in the observation group were lower than those in the control group(P<0.05).At 1 d after operation,the levels of vascular endothelial growth factor(VEGF),basic fibroblast growth factor(bFGF)and epidermal growth factor(EGF)in the observation group were higher than those in the control group(P<0.05).At 1 week after operation,the wound granulation growth score of the observation group was higher than that of the control group,and the Visual Analogue Scale(VAS)score was lower than that of the control group(P<0.05);at 4 weeks after operation,there were no significant differences in wound granulation growth score and VAS score between the two groups(P>0.05);the wound healing time of the observation group was shorter than that of the control group(P<0.05).Conclusion Local irregular transfer flap in the treatment of patients with sacrococcygeal pilonidal sinus has a significant effect.It can reduce the body's traumatic stress response,regulate the level of growth factors,and promote rapid wound healing,which is worthy of promotion.

关 键 词：局部不规则转移皮瓣术 骶尾部藏毛窦 创伤应激反应 创面愈合 

分 类 号：R635[医药卫生—外科学]