游离股前外侧皮瓣修复足踝创伤的临床疗效  

Discussion on the survival of wound flap in the treatment of foot and ankle trauma with free anterolateral femoral flap transplantation and repair

作　　者：陈维维 方三华 应康杰 童舜谊 CHEN Weiwei;FANG Sanhua;YING Kangjie;TONG Shunyi(Lanxi People’s Hospital,Lanxi 321102,China)

机构地区：[1]兰溪市人民医院,浙江兰溪321102

出　　处：《浙江实用医学》2023年第2期111-115,共5页Zhejiang Practical Medicine

摘　　要：目的探讨游离股前外侧皮瓣修复足踝创伤的临床疗效。方法选取2017年1月~2022年1月在浙江省兰溪市人民医院治疗的足踝创伤患者89例,根据信封法随机分为股前组46例和腓肠组43例,股前组接受游离股前外侧皮瓣移植修复,腓肠组接受腓肠神经营养皮瓣治疗,观察两组皮瓣愈合情况(创面愈合时间、皮瓣一次成活率、皮瓣两点辨别觉距离),同时采用Holden步行功能分级量表评价患者行走能力,采用SF-36量表评估患者生活质量。结果股前组创面愈合时间(13.39±2.28)天,时间短于腓肠组(18.28±2.80)天,差异具有统计学意义(P<0.01);股前组皮瓣两点辨别觉距离为(4.50±1.12)mm,明显小于腓肠组(5.98±1.07)mm,差异具有统计学意义(P<0.01)。术后6个月,股前组行走能力优于腓肠组,差异具有统计学意义(Z=-2.355,P=0.019),其中股前组Holden步行功能Ⅳ-Ⅴ级比例达73.91%优于腓肠组46.51%,差异具有统计学意义(X^(2)=4.930,P<0.05);股前组术后6个月SF-36量表生理功能、总体健康、活力、情感职能和精神健康评分均明显高于腓肠组,而躯体疼痛评分明显低于腓肠组,差异均有统计学意义(P<0.05或P<0.01)。结论游离股前外侧皮瓣修复足踝创伤皮瓣愈合较好,且能明显改善患者术后行走能力和生活质量。Objective To investigate the clinical effect of free anterolateral femoral flap transplantation in the treatment of foot and ankle trauma.Methods A total of 89 patients with foot and ankle trauma who were treated in Lanxi People’s Hospital of Zhejiang Province from January 2017~January 2022 were selected,46 cases in the anterior lateral thigh flap group and 43 cases in the sural nerve nutrient flap group were randomly randomized according to the envelope method,the prefemoral group received free anterolateral femoral flap transplantation and repair,and the sural group received sural neurotrophic flap treatment,and the healing status of the flap(wound healing time,flap survival rate,and two-point discrimination distance of the flap)was observed.The SF-36 scale was used to evaluate the quality of life of patients.Results The wound healing time of the prefemoral group was(13.39±2.28)days,which was significantly faster than that of the sural group(18.28±2.80)days,the difference was statistically significant(P<0.01).The two-point discriminatory distance of the skin flap in the prefemoral group was(4.50±1.12)mm,which was significantly smaller than that in the sural group(5.98±1.07)mm,the difference was statistically significant(P<0.01).The walking ability of the prefemoral group was better than that of the sural group at 6 months after surgery,the difference was statistically significant(Z=-2.355,P=0.019),and the proportion of grade IV.-V walking function in the prefemoral group was 73.91%(34/46),which was better than that of the sural group 46.51%(20/43),the difference was statistically significant(X^(2)=4.930,P<0.05).The scores of physiological function,general health,vitality,emotional function and mental health of the SF-36 scale at 6 months after surgery in the prefemoral group were significantly higher than those in the sural group,while the scores of physical pain were significantly lower than those in the sural group,the differences were statistically significant(P<0.05 or P<0.01).Conclusion The free ante

关 键 词：足踝创伤 游离股前外侧皮瓣修复 腓肠神经营养皮瓣 

分 类 号：R658.3[医药卫生—外科学]