带蒂旋髂浅动脉穿支皮瓣与躯干任意皮瓣修复手部电击伤致软组织缺损疗效对比  

Comparison of Clinical Efficacy of Pedicled Superficial Circumflex Iliac Artery Perforator Flap and Arbitrary Flap from Trunk in Repairing Hand Soft Tissue Defect Caused by Electric Shock

作　　者：孙佳琳 郑伟才[1] 李庆华[1] 樊磊 SUN Jialin;ZHENG Weicai;LI Qinghua;FAN Lei(Department of Burns and Plastic Surgery,The First Affiliated Hospital of Henan University of Science and Technology,Luoyang,Henan 471000,China)

机构地区：[1]河南科技大学第一附属医院烧伤整形外科,河南洛阳471000

出　　处：《中国烧伤创疡杂志》2024年第3期196-200,共5页The Chinese Journal of Burns Wounds & Surface Ulcers

基　　金：洛阳市科技计划项目(2101039A)。

摘　　要：目的对比分析带蒂旋髂浅动脉穿支皮瓣与躯干任意皮瓣修复手部电击伤致软组织缺损的临床疗效。方法选取2017年5月至2022年6月河南科技大学第一附属医院收治的82例手部电击伤致软组织缺损患者作为研究对象,按照不同治疗方式将其分为试验组(40例)和对照组(42例),试验组患者软组织缺损创面采用带蒂旋髂浅动脉穿支皮瓣进行修复,对照组患者软组织缺损创面采用躯干任意皮瓣进行修复,对比观察两组患者皮瓣血管蒂长度、住院时间、创面愈合时间、手指关节总主动活动度、皮瓣受区支配区域感觉功能与并发症(淋巴瘘、血管危象、瘢痕挛缩)发生情况。结果试验组患者皮瓣血管蒂长度为(789±113)cm,明显长于对照组患者的皮瓣血管蒂长度(629±121)cm(t=6181,P<0001);住院时间为(3114±492)d、创面愈合时间为(4019±1023)d,明显短于对照组患者的住院时间(3358±503)d、创面愈合时间(4662±1141)d(t=2219、2682,P=0029、0009)。术后4个月,试验组患者手指关节总主动活动度为良20例、中16例、差4例,明显优于对照组患者的手指关节总主动活动度为良10例、中20例、差12例(Z=-2762,P=0006);试验组患者皮瓣受区支配区域感觉功能为5级8例、4级12例、3级11例、2级7例、1级2例,明显优于对照组患者的皮瓣受区支配区域感觉功能为5级1例、4级10例、3级10例、2级13例、1级7例、0级1例(Z=-3005,P=0002)。试验组患者术后并发症发生率为1750%,明显低于对照组患者的术后并发症发生率4048%(χ^(2)=5224,P=0022)。结论与躯干任意皮瓣相比,带蒂旋髂浅动脉穿支皮瓣可有效修复手部电击伤所致的软组织缺损,促进手部运动功能及感觉功能恢复,降低淋巴瘘等并发症发生率。Objective To compare the clinical efficacy of pedicled superficial circumflex iliac artery perforator flap and arbitrary flap from trunk in repairing hand soft tissue defect caused by electric shock.Methods 82 patients with hand soft tissue defect caused by electric shock,admitted to The First Affiliated Hospital of Henan University of Science and Technology from May 2017 to June 2022,were enrolled as research subjects to be divided into the experiment group(n=40)and the control group(n=42)based on different treatment methods.The soft tissue defects of patients in the experi-ment group were repaired with pedicled superficial circumflex iliac artery perforator flap,whereas the soft tissue defects of patients in the control group were repaired with arbitrary flap from trunk.The length of flap vascular pedicle,length of stay,wound healing time,total active motion range of finger joint,sensory function of flap recipient-dominating area,and the occurrence of the complications(lymphatic fistula,vascular crisis,and scar contracture)were compared between the two groups.Results The length of flap vascular pedicle of patients in the experiment group was(789±113)cm,which was significantly longer than the(629±121)cm in the control group(t=6181,P<0001).The length of stay and wound healing time were respectively(3114±492)d and(4019±1023)d in the experiment group,which were significantly shorter than the corresponding(3358±503)d and(4662±1141)d in the control group(t=2219 and 2682,P=0029 and 0009).At four months after surgery,the total active motion range of finger joint was evaluated as good in 20 cases,fair in 16 cases and poor in 4 cases in the experiment group,which was significantly better than that in the control group-good in 10 cases,fair in 20 cases and poor in 12 cases(Z=-2762,P=0006).The sensory function of flap recipient-dominating area was grade 5 in 8 cases,grade 4 in 12 cases,grade 3 in 11 cases,grade 2 in 7 cases,and grade 1 in 2 cases in the experiment group,which was obviously superior to that in the con

关 键 词：带蒂旋髂浅动脉穿支皮瓣 任意皮瓣 手 电击伤 软组织缺损 总主动活动度 感觉功能 

分 类 号：R647[医药卫生—外科学]