前臂掌侧静脉皮瓣和SPBRA皮瓣桥接修复伴有指掌侧固有动脉缺损的手指创面患者的效果对比  

Comparison of the Effect of the Palmar Forearm Vein Flap and SPBRA Flap Bridging in Repairing Finger Wound with Defect in the Palmar Proper Artery of the Fingers

作　　者：张雅营 ZHANG Yaying(Jiaocheng District Hospital of Ningde City,Ningde 352100,China)

机构地区：[1]宁德市蕉城区医院,福建宁德352100

出　　处：《中外医学研究》2023年第32期124-128,共5页CHINESE AND FOREIGN MEDICAL RESEARCH

摘　　要：目的:分析并比较前臂掌侧静脉皮瓣和桡动脉掌浅支(SPBRA)皮瓣桥接修复伴有指掌侧固有动脉缺损的手指创面患者的效果。方法:选取2018年3月—2022年12月宁德市蕉城区医院收治的75例伴有指掌侧固有动脉缺损的手指创面患者,按照治疗方式的不同将其分为两组,A组(n=37)给予前臂掌侧静脉皮瓣修复,B组(n=38)给予SPBRA皮瓣桥接修复,观察比较两组手术相关情况、指间关节活动度、感觉功能、并发症发生率及皮瓣存活率。结果:两组手术时间、皮瓣制作时间比较,差异无统计学意义(P>0.05),B组创面愈合时间短于A组,差异有统计学意义(P<0.05)。术后6个月,两组近、远指间关节屈曲活动度均高于术前,但两组间比较,差异无统计学意义(P>0.05)。术后6个月,B组患指感觉功能优于A组,静止两点辨别觉(S2-PD)高于A组,差异有统计学意义(P<0.05)。B组皮瓣成活率为89.47%(34/38),高于A组的70.27%(26/37),差异有统计学意义(χ^(2)=4.321,P=0.038)。两组各项并发症发生率比较,差异无统计学意义(P>0.05)。结论:在伴有指掌侧固有动脉缺损的手指创面患者中应用前臂掌侧静脉皮瓣、SPBRA皮瓣桥接修复手术效果相当,具有一定安全性,但SPBRA皮瓣桥接修复手术皮瓣存活率更高,能够有效改善患者感觉功能,促进创面恢复。Objective:To analyze and compare the effect of the palmar forearm vein flap and the superficial palmar branch radial artery(SPBRA)flap bridging in repairing the finger wound with defect in the palmar proper artery of the fingers.Method:A total of 75 patients with finger wound with defect in the palmar proper artery of the fingers treated in Jiaocheng District Hospital of Ningde City from March 2018 to December 2022 were selected and divided into two groups according to different treatment methods.Group A(n=37)was given palmar forearm vein flap repair;group B(n=38)was given SPBRA flap bridge repair.The operative conditions,interphalangeal joint motion,sensory function,complication rate and flap survival rate were observed and compared in the two groups.Result:There were no significant differences in surgery time and flap making time between the two groups(P>0.05).The wound healing time in group B was shorter than that in group A,and the difference was statistically significant(P<0.05).At 6 months after surgery,the flexion motion of proximal and distal interphalangeal joint in both groups were higher than those before surgery,but there were no significant differences between the two groups(P>0.05).At 6 months after surgery,the sensory function of the affected finger in group B was better than that in group A,and static 2-point discrimination(S2-PD)was higher than that in group A,the differences were statistically significant(P<0.05).The survival rate of flaps in group B was 89.47%(34/38),which was higher than 70.27%(26/37)in group A,the difference was statistically significant(X^(2)=4.321,P=0.038).There was no significant difference in the incidence of complications between the two groups(P>0.05).Conclusion:In patients with finger wound with defect in the palmar proper artery of the fingers,palmar forearm vein flap and SPBRA flap bridging surgery have similar results and have certain safety.However,SPBRA flap bridging surgery has a higher survival rate,which can effectively improve patients'sensory function and pro

关 键 词：前臂掌侧静脉皮瓣 桡动脉掌浅支 指掌侧固有动脉缺损 手指创面 感觉功能 

分 类 号：R658.2[医药卫生—外科学]