甲板甲床部分切除术联合改良Bartlett手术治疗嵌甲性甲沟炎效果观察  

Observation on the effect of partial nail bed excision combined with modified Bartlett operation in the treatment of ingrown paronychia

作　　者：薛鑫鑫[1] 王培[1] XUE Xinxin;WANG Pei(Department of Hand-foot Surgery,Affiliated Hospital of Chengde Medical College,Chengde 067000,China)

机构地区：[1]承德医学院附属医院手足外科,河北承德067000

出　　处：《中国美容整形外科杂志》2024年第12期730-734,共5页Chinese Journal of Aesthetic and Plastic Surgery

基　　金：承德市科技计划项目(201804A027)。

摘　　要：目的 观察甲板甲床部分切除术联合改良Bartlett手术治疗嵌甲性甲沟炎的效果。方法 自2018年4月至2021年4月,承德医学院附属医院手足外科收治96例嵌甲性甲沟炎患者,依据治疗方法分为两组。对照组:接受常规拔甲术的42例患者;观察组:接受甲板甲床部分切除术联合改良Bartlett手术治疗的54例患者,比较两组患者术后恢复情况。随访6个月,比较两组临床疗效、感染情况和生活质量。创面情况采用视觉模拟(visual analogue scale,VAS)评分,生活质量采用卡氏功能状态评分(karnofsky performance scale,KPS)。结果 与对照组比较,观察组创面红肿时间、愈合时间较短,换药次数较少,VAS评分较低,两组比较,差异有统计学意义(t=13.909,10.906,11.730,18.810;P<0.05)。随访发现,观察组一次性治愈率(98.15%)高于对照组(78.57%),两组治愈率比较,差异有统计学意义(χ^(2)=9.703,P=0.002),而两组感染发生率(1.85%∶7.14%)比较,差异无统计学意义(χ^(2)=1.656,P=0.198)。末次随访时,观察组KPS评分[(94.16±3.28)分]高于对照组[(86.44±5.08)分],组间比较差异有统计学意义(t=9.016,P<0.05)。结论 甲板甲床部分切除术联合改良Bartlett手术治疗嵌甲性甲沟炎临床效果确切,可缩短创面愈合时间,且一次性治愈率较高,预后较好。Objective To observe the clinical effect of partial nail bed excision combined with modified Bartlett operation in the treatment of ingrown paronychia.Methods A total of 96 patients with ingrown paronychia admitted to the hospital from April 2018 to April 2021 were selected,the 42 patients who received conventional nail extraction were defined as the control group,54 patients who received partial nail bed resection combined with modified Bartlett surgery were defined as the observation group,the postoperative recovery of the two groups of patients was compared.The two groups were followed up for 6 months to compare the clinical efficacy,infection and quality of life.Results Compared with the control group,the observation group had shorter wound redness and swelling time,shorter healing time,fewer dressing changes,and lower VAS score,and the differences between the groups were statistically significant(t=13.909,10.906,11.730,18.810;P<0.05).Follow-up found that the one-time cure rate of the observation group was 98.15% higher than that of the control group,78.57%,with a significant difference between the groups(χ~2=9.703,P=0.002);there was no significant difference in the incidence of infection between the two groups(1.85%∶7.14%;χ~2=1.656,P=0.198).At the last follow-up,the KPS score of the observation group(94.16±3.28) was higher than that of the control group(86.44±5.08),and the difference between the groups was significant(t=9.016,P<0.05).Conclusion Partial decknail bed resection combined with modified Bartlett operation in the treatment of onychoglitis has definite clinical effect,can shorten the wound healing time,and has a high one-time cure rate and good prognosis.

关 键 词：甲沟炎 嵌甲 甲板甲床部分切除术 改良Bartlett手术 

分 类 号：R632.7[医药卫生—外科学]