小腿岛状穿支蒂螺旋桨皮瓣与股前外侧皮瓣在足踝部复合组织缺损患者治疗中的修复效果及并发症发生情况  

Analysis of the repair effect and complications of the thigh island perforating pedicle propeller flap and anterolateral thigh flap in the treatment of foot and ankle complex tissue defect

作　　者：施明宏 程建和 张炬云 SHI Minghong;CHENG Jianhe;ZHANG Juyun(Department of Orthopaedics,Yingtan Medical District,908 Hospital of the Joint Service Support Force of the Chinese People's Liberation Army,Yingtan,Jiangxi,335000,China;Department of Orthopaedics,Jingdezhen Changjiang Hospital,Jingdezhen,Jiangxi,333030,China)

机构地区：[1]中国人民解放军联勤保障部队第九〇八医院鹰潭医疗区骨科,江西鹰潭335000 [2]景德镇昌江医院骨科,江西景德镇333030

出　　处：《当代医学》2024年第19期55-59,共5页Contemporary Medicine

摘　　要：目的探究小腿岛状穿支蒂螺旋桨皮瓣与股前外侧皮瓣在足踝部复合组织缺损患者治疗中的修复效果及并发症发生情况。方法选取2019年1月至2021年12月中国人民解放军联勤保障部队第九〇八医院收治的86例足踝部复合组织缺损患者作为研究对象,根据不同治疗方案分为A组与B组,每组43例。A组采用小腿岛状穿支蒂螺旋桨皮瓣修复治疗,B组采用股前外侧皮瓣修复治疗。比较两组手术相关指标、皮瓣成活率、术后疼痛情况、足踝部功能、皮肤感觉、外观满意度及术后并发症发生情况。结果B组手术时间长于A组,皮瓣愈合时间短于A组,差异有统计学意义(P<0.05);两组皮瓣成活率均为100.00%,组间比较差异无统计学意义。术前及术后3、7、28 d时,两组视觉模拟评分法(visual analog scale,VAS)评分比较差异无统计学意义;术后14 d时,B组VAS评分低于A组,差异有统计学意义(P<0.05)。术后6个月,B组美国足与踝关节协会踝-后足评分高于A组,差异有统计学意义(P<0.05)。两组术后6个月皮瓣感觉情况及外观满意度、并发症发生率比较差异均无统计学意义。结论股前外侧皮瓣治疗足踝部复合组织缺损患者疗效显著,可缩短皮瓣愈合时间,促进术后足踝部功能恢复,且未增加术后并发症,安全性较高。Objective To investigate the repair effect and complications of the thigh island perforating pedicle propeller flap and anterolateral thigh flap in the treatment of foot and ankle complex tissue defect.Methods A total of 86 patients with foot and ankle complex tissue defect admitted to the 908 Hospital of the Joint Service Support Force of the Chinese People's Liberation Army from January 2019 to December 2021 were selected as the study subjects,and they were divided into the group A and the group B according to different treatment plans,with 43 cases in each group.The lower leg island perforated propeller flap was used in group A,and the anterolateral thigh flap was used in group B.The postoperative indexes,survival rate of skin flap,postoperative pain,foot and ankle function,skin sensation,satisfaction of repair treatment and postoperative complications were compared between the two groups.Results The operation time in the group B was longer than that in the group A,and the flap healing time was shorter than that in the group A,the differences were statistically significant(P<0.05).The survival rate of the two groups was 100.00%,and there was no significant difference between the two groups.There was no significant difference in visual analogue scale(VAS)scores between the two groups before surgery and 3,7 and 28 d after surgery;at 14 d after surgery,the VAS score in the group B was lower than that in the group A,and the difference was statistically significant(P<0.05).6 months after surgery,the American Orthopedic Foot and Ankle Society ankle-hind foot score in the group B was higher than that in the group A,and the difference was statistically significant(P<0.05).There was no significant difference in skin flap sensation at 6 months after operation,appearance satisfaction and incidence of complications between the two groups.Conclusion Anterolateral thigh flap is effective in the treatment of complex tissue defect of foot and ankle,which can shorten the healing time of the flap,promote the functional recovery

关 键 词：足踝部复合组织缺损 股前外侧皮瓣 治疗效果 并发症 

分 类 号：R658.3[医药卫生—外科学]