手指腹部带蒂皮瓣术与岛状皮瓣修复术治疗手外伤患者的临床疗效  

Clinical efficacy of finger abdominal pedicled skin flap and island flap repair in the treatment of hand injur

作　　者：赵浩呈[1] 黄小磊 王瑞良[1] ZHAO Haocheng;HUANG Xiaolei;WANG Ruiliang(Department of Orthopaedics,Nantong Ruici Hospital,Nantong,Jiangsu,226010,China)

机构地区：[1]南通瑞慈医院骨科,江苏南通226010

出　　处：《当代医学》2024年第13期42-46,共5页Contemporary Medicine

摘　　要：目的探讨手指腹部带蒂皮瓣修复术、岛状皮瓣修复术治疗手外伤患者的临床疗效。方法选取2020年1月至2022年6月就诊于南通瑞慈医院的72例手外伤患者作为研究对象,按照手术治疗方式不同分为参照组与研究组,每组36例。参照组采用手指腹部带蒂皮瓣修复术治疗,研究组采用岛状皮瓣修复术治疗。比较两组修复优良率、皮瓣存活率、恢复时间、术后并发症发生率、炎症细胞因子[超敏C反应蛋白(hs-CRP)、白细胞介素-6(IL-6)、白细胞介素-8(IL-8)]水平、疼痛程度[视觉模拟评分法(VAS)评分]、手功能[密歇根手功能量表(MHQ)评分]、生命质量(Barthel指数评分)、修复满意度。结果研究组修复优良率、皮瓣存活率均高于参照组,差异有统计学意义(P<0.05)。研究组创面痊愈时间、总住院时间均短于参照组,差异有统计学意义(P<0.05)。研究组术后并发症发生率低于参照组,差异有统计学意义(P<0.05)。术后,两组hs-CRP、IL-6、IL-8水平均低于术前,且研究组低于参照组,差异有统计学意义(P<0.05)。术后,两组VAS评分均低于术前,MHQ、Barthel指数评分均高于术前,且研究组VAS评分低于参照组,MHQ、Barthel指数评分均高于参照组,差异有统计学意义(P<0.05)。研究组修复满意度高于参照组,差异有统计学意义(P<0.05)。结论与手指腹部带蒂皮瓣修复术比较,岛状皮瓣修复术治疗手外伤疗效更佳,可提高皮瓣存活率、修复优良率,可加快创面愈合,减少术后并发症,缩短住院时间,减轻疼痛,降低炎症反应,增强手部功能,提高患者生命质量。Objective To investigate the clinical efficacy of finger abdominal pedicled skin flap and island skin flap in the treatment of hand injuries.Methods 72 patients with hand injuries admitted to Nantong Ruici Hospital from January 2020 to June 2022 were selected as the study subjects,and they were divided into the reference group and the study group according to the different surgical treatment,with 36 cases in each group.The reference group was treated with abdominal pedicled flap repair,and the study group was treated with island flap repair.The excellent and good rate of repair,skin flap survival rate,recovery time,incidence of postoperative complications,inflammatory cytokines(hypersensitive C-reactive protein[hs-CRP],interleukin-6[IL-6],interleukin-8[IL-8])levels,pain degree(visual analogue scale[VAS]score),hand function(Michigan hand outcomes questionnaire[MHQ]score),quality of life(Barthel index score),and repair satisfaction were compared between the two groups.Results The excellent and good rate of repair and the survival rate of skin flap in the study group were higher than those in the reference group,and the differences were statistically significant(P<0.05).The wound healing time and total hospital stay in the study group were shorter than those in the reference group,and the differences were statistically significant(P<0.05).The incidence of postoperative complications in the study group was lower than that in the reference group,and the difference was statistically significant(P<0.05).After operation,the hs-CRP,IL-6 and IL-8 levels of the two groups were lower than those before operation,and the study group was lower than the reference group,and the differences were statistically significant(P<0.05).After operation,the VAS score of the two groups was lower than that before operation,and the MHQ and Barthel index scores were higher than those before operation,and the VAS score in the study group was lower than that in the reference group,and the MHQ and Barthel index scores were higher than those in th

关 键 词：手外伤 腹部带蒂皮瓣 岛状皮瓣 炎症细胞因子 疼痛程度 

分 类 号：R658.2[医药卫生—外科学]