指侧方皮瓣修复术治疗伴皮肤缺损断指再植的临床效果  

Clinical effect of lateral finger flap repair for replantation of severed fingers with skin defects

作　　者：王仁款 孙学强 赵振程 赵树林 WANG Ren-kuan;SUN Xue-qiang;ZHAO Zhen-cheng(Department of Emergency Surgery(Microsurgery),Tongji University Affiliated East Hospital Jiaozhou Hospital,Qingdao 266300,China)

机构地区：[1]同济大学附属东方医院胶州医院急诊外科(显微外科),266300

出　　处：《中国实用医药》2024年第21期30-34,共5页China Practical Medicine

摘　　要：目的 探讨伴皮肤缺损(SD)断指再植患者采用指侧方皮瓣修复术治疗的临床效果。方法 选取44例伴SD断指再植患者,以随机数字表法分成研究组(n=22)和对照组(n=22)。对照组给予静脉皮瓣修复术治疗,研究组给予指侧方皮瓣修复术治疗。比较两组手术优良率、损指功能、炎症因子水平、术后并发症发生情况。结果 研究组手术优良率为100.00%(22/22),与对照组的72.73%(16/22)相比更高(P<0.05)。术后1个月,两组关节自主活动度、日常活动、外观、血液循环评分均较术前升高,且与对照组的(15.02±2.34)、(15.34±2.41)、(16.43±2.52)、(7.26±1.36)分相比,研究组关节自主活动度评分(16.94±2.25)分、日常活动评分(17.15±2.07)分、外观评分(18.05±1.77)分、血液循环评分(8.33±1.48)分更高(P<0.05)。术后1个月,两组白细胞介素-6(IL-6)、C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)、干扰素-γ(INF-γ)水平均较术前降低,且与对照组的(171.86±14.31)ng/ml、(4.03±0.98)mg/L、(109.88±8.92)pg/ml、(500.87±17.32)ng/ml相比,研究组IL-6(162.37±12.43)ng/ml、CRP(3.21±0.94)mg/L、TNF-α(98.45±7.34)pg/ml、INF-γ(441.26±15.44)ng/ml更低(P<0.05)。研究组术后并发症发生率为4.55%(1/22),与对照组的36.36%(8/22)相比更低(P<0.05)。结论 伴SD断指再植患者采用指侧方皮瓣修复术治疗,能够提高手术优良率,改善损指功能及炎症因子水平,降低术后并发症发生率。Objective To explore the clinical effect of lateral finger flap repair for replantation of severed fingers with skin defects(SD).Methods A total of 44 patients with replantation of severed fingers and SD were selected,and divided into the study group(n=22)and the control group(n=22).The control group received venous flap repair,and the study group received lateral finger flap repair.The surgical excellent rate,finger function,inflammatory cytokine levels,and postoperative complications in both groups were compared.Results The surgical excellence rate of 100.00%(22/22)in the study group was higher than 72.73%(16/22)in the control group(P<0.05).1 month after surgery,the scores of joint voluntary motion,daily activity,appearance and blood circulation in both groups were higher than those before surgery;the scores of joint voluntary motion,daily activity,appearance and blood circulation were(16.94±2.25),(17.15±2.07),(18.05±1.77)and(8.33±1.48)points in the study group,which were higher than(15.02±2.34),(15.34±2.41),(16.43±2.52)and(7.26±1.36)points in the control group(P<0.05).1 month after surgery,the levels of interleukin-6(IL-6),C-reactive protein(CRP),tumor necrosis factor-α(TNF-α)and interferon-γ(INF-γ)in both groups were lower than those before surgery;the levels of IL-6,CRP,TNF-αand INF-γwere(162.37±12.43)ng/ml,(3.21±0.94)mg/L,(98.45±7.34)pg/ml and(441.26±15.44)ng/ml in the study group,which were lower than(171.86±14.31)ng/ml,(4.03±0.98)mg/L,(109.88±8.92)pg/ml and(500.87±17.32)ng/ml in the control group(P<0.05).The incidence of postoperative complications was 4.55%(1/22)in the study group,which was lower than 36.36%(8/22)in the control group(P<0.05).Conclusion The use of lateral finger flap repair in patients with replantation of severed fingers and SD can improve the surgical success rate,improve finger function and inflammatory cytokine levels,and reduce the incidence of postoperative complications.

关 键 词：指侧方皮瓣修复术 皮肤缺损 断指再植 临床效果 

分 类 号：R658.1[医药卫生—外科学]