腓肠神经营养血管皮瓣与小腿胫后动脉穿支皮瓣修复足踝部创面的效果对比  

Comparison of the effect of sural nerve vascular flap and inner and outer calf flap in repairing wounds of foot and ankle

作　　者：蔡青松 邵文年 赵玉华 周卫松 李建银 Cai Qingsong;Shao Wennian;Zhao Yuhua;Zhou Weisong;Li Jianyin(Orthopaedics,Yancheng Tongzhou Orthopaedic Hospital,Yancheng 224007,China;Orthopaedics,Yancheng Desai Fort Hospital,Yancheng 224000,China)

机构地区：[1]盐城同洲骨科医院骨科,江苏盐城224007 [2]盐城德赛堡医院骨科,江苏盐城224000

出　　处：《足踝外科电子杂志》2023年第3期29-33,共5页Electronic Journal of Foot and Ankle Surgery

基　　金：2020年盐城市医学科技发展计划项目(YK2020058)。

摘　　要：目的探究腓肠神经营养血管皮瓣与小腿胫后动脉穿支皮瓣修复足踝部创面的临床效果。方法回顾分析近两年盐城同洲骨科医院骨科接收的103例足踝部创伤患者作为研究对象,最早入院时间为2020年2月,最晚为2022年2月。依据患者接受的修复方案进行分组,接受小腿胫后动脉穿支皮瓣修复手术的49例患者作为对照组,接受腓肠神经营养血管皮瓣修复手术的54例患者作为研究组。治疗后,以患者足踝部功能、手术时间、皮瓣修复效果、并发症发生情况、术后愈合效果等作为观察指标,对比两组患者的创面治疗效果。结果治疗后,组间足踝部功能分值对比无显著差异(P>0.05);研究组的手术时间与对照组相比显著更低(P<0.05);与对照组相比,研究组的皮瓣长度、皮瓣宽度数值均更高(P<0.05);研究组术后创面愈合优良率与对照组对比无显著差异(P>0.05);研究组术后并发症发生率为3.70%,高于对照组的16.33%(P<0.05)。结论小腿胫后动脉穿支皮瓣修复与腓肠神经营养血管皮瓣修复术治疗足踝创面均能取得良好效果,帮助患者恢复足踝部功能,但后者术后并发症更少,安全性方面略有优势,临床可依据患者实际情况选择手术方案。Objective To compare the clinical effect of sural nerve nutrient vessel flap and posterior tibial artery perforator flap in repairing the wound of foot and ankle.Methods A retrospective analysis was made of 103 patients with foot and ankle trauma received by the orthopedic department of Yancheng Tongzhou Orthopedic Hospital in the past two years.The earliest admission time was February 2020,and the latest was February 2022.The patients were grouped according to the repair plan accepted by the patients.49 patients who received the repair of the perforating branch skin flap of the posterior tibial artery of the lower leg were used as the control group,and 54 patients who received the repair of the sural neurovascular flap were used as the study group.After treatment,The wound treatment effects of the two groups were compared with the ankle function,operation time,flap repair effect,complications and postoperative healing effect of the patients as the observation indicators.Results After treatment,there was no significant difference in foot and ankle function scores between groups(P>0.05).The operation time of the study group was significantly lower than that of the control group(P<0.05).Compared with the control group,the flap length and flap width were higher in the study group(P<0.05).There was no significant difference in postoperative wound healing rate between the study group and the control group(P>0.05).However,the incidence of postoperative complications was 3.70%in the study group and 16.33%in the control group,and the incidence was lower in the study group compared with each other(P<0.05).However,the incidence of postoperative complications in the study group was 3.70%,and that in the control group was 16.33%.The incidence of postoperative complications in the study group was lower(P<0.05).Conclusion The repair of the perforating branch of the posterior tibial artery flap of the leg and the repair of the sural nerve nutrient vessel flap can achieve good results in the treatment of the foot and ankle wound

关 键 词：腓肠神经营养血管皮瓣 小腿胫后动脉穿支皮瓣 足踝部创面 

分 类 号：R658.3[医药卫生—外科学]