不同修复术处理指端缺损效果及对炎症-氧化应激的影响  

Effect of Different Prosthetics on Finger Defects and Their Effectson Inflammatory and Oxidative Stress

作　　者：裴金乐 杜治昆 刘念[1] 付勇力 韩魏魏 李都 程龙 PEI Jinle;DU Zhikun;LIU Nian;FU Yongli;HAN Weiwei;LI Du;CHENG Long(Department of Osteoarthritis,Nanyang Central Hospital,Nanyang 473005,China;Emergency surgery,Nanyang Central Hospital,Nanyang 473005,China)

机构地区：[1]南阳市中心医院骨关节科,河南南阳473005 [2]南阳市中心医院急诊外科,河南南阳473005

出　　处：《河南医学研究》2024年第7期1281-1284,共4页Henan Medical Research

摘　　要：目的探讨不同修复术处理指端缺损的效果。方法选取2020年2月至2022年8月南阳市中心医院指端缺损者80例,依据治疗方案分为研究组、对照组,各40例。对照组行桡背侧皮瓣修复术,研究组行拇指桡侧穿支螺旋桨皮瓣修复术。比较两组围手术期指标、并发症以及手指功能[密歇根手功能量表(MHQ)评分、关节活动度(TAM)]、炎症指标[白介素-10(IL-10)、肿瘤坏死因子-α(TNF-α)]、氧化应激指标[促肾上腺皮质激素(ACTH)、皮质醇(Cor)]。结果与对照组相比,研究组两点辨别觉缩短,创面完全愈合时间减少(P<0.05);术后6个月研究组MHQ评分、TAM均高于对照组(P<0.05)。术后3 d,两组血清TNF-α、IL-10水平高于术前(P<0.05);ACTH、Cor水平均高于术前(P<0.05);研究组皮瓣瘀紫发生率低于对照组(P<0.05)。结论拇指桡侧穿支螺旋桨与桡背侧皮瓣修复术治疗指端缺损患者引起炎症-氧化应激接近,但拇指桡侧穿支螺旋桨皮瓣修复术可促进康复,改善手功能,保障安全性。Objective To investigate the effect of different prosthetics on finger defect and the effect of inflammation and oxidative stress.Methods A total of 80 patients with fingertip defect treated Nanyang Central Hospital from February 2020 to August 2022 were selected as research objects and divided into study group and control group with 40 cases in each group according to different treatment plans.The control group underwent radial dorsal flap repair and the study group underwent thumb radial perforator propeller flap repair.Perioperative indexes,complications,finger function[Michigan hand function scale(MHQ)score,range of motion(TAM)],inflammatory indexes[interleukin-10(IL-10),tumor necrosis factor-α(TNF-α)],oxidative stress indexes[adrenocorticotropic hormone(ACTH),cortex]were compared between the two groups before and 6 months after surgery Alcohol(Cor)].Results Compared with the control group,the study group had a shorter two-point discrimination and a shorter time for complete wound healing(P<0.05),After 6 months of surgery,the MHQ score and TAM in the study group were higher than those in the control group(P<0.05).Three days after surgery,serum TNF-α,IL-10 levels in both groups were higher than preoperative(P<0.05).ACTH and Cor levels were higher than preoperative levels(P<0.05).The incidence of skin flap bruising in the study group was lower than that in the control group(P<0.05).Conclusion Thumb radial penetrating propeller and radial dorsal flap repair for the treatment of patients with fingertip defects can cause inflammatory-oxidative stress close to each other,but thumb radial penetrating propeller flap repair can promote healing,improve hand function,and guarantee safety.

关 键 词：皮瓣修复术 穿支螺旋桨 拇指桡侧 指端缺损 炎症反应 氧化应激 

分 类 号：R687[医药卫生—骨科学]