足底内侧皮瓣与腓肠神经营养血管皮瓣在足跟部软组织缺损修复中的临床疗效比较  

Comparison of clinical efficacy of medial plantar flap and sural neurovascular flap in the repair of heel soft tissue defect

作　　者：陈强 刘鹏[1] 蔡飞 赵建武[1] CHEN Qiang;LIU Peng;CAI Fei(Department of Hand-foot Microsurgery,The First Hospital of Yulin,Yulin Shaanxi 719000,China)

机构地区：[1]榆林市第一医院手足显微外科,陕西榆林719000

出　　处：《临床和实验医学杂志》2025年第3期292-295,共4页Journal of Clinical and Experimental Medicine

基　　金：陕西省重点研发计划项目(编号:2019SF-191)。

摘　　要：目的比较足底内侧皮瓣与腓肠神经营养血管皮瓣在足跟部软组织缺损修复中的临床疗效。方法回顾性选取2020年1月至2024年1月榆林市第一医院收治入院的92例足跟部出现软组织缺损状况的患者,按照修复皮瓣的不同分为足底组(n=46)与腓肠组(n=46)。足底组修复选取足底内侧皮瓣,腓肠组修复选取腓肠神经营养血管皮瓣。比较两组患者的手术指标(皮瓣完全成活率、术中出血量、皮瓣切取移植时间),术前、术后3个月的美国足踝外科协会(AOFAS)踝-后足评分、术后3个月的英国医学研究会(BMRC)感觉功能分级和皮瓣外观满意度。结果足底组患者术后皮瓣完全成活率为97.83%,高于腓肠组(82.61%),足底组患者的术中出血量为(101.84±1.69)mL,低于腓肠组[(104.37±2.08)mL],皮瓣切取移植时间为(61.53±5.52)min,短于腓肠组[(65.68±5.21)min],差异均有统计学意义(P<0.05)。术后3个月,两组患者的AOFAS踝-后足评分均高于术前,且足底组患者的AOFAS踝-后足评分为(84.92±5.14)分,高于腓肠组[(79.63±5.02)分],差异均有统计学意义(P<0.05)。足底组患者术后BMRC感觉功能分级明显优于腓肠组,差异有统计学意义(P<0.05)。足底组患者术后皮瓣外观总满意度为95.65%,高于腓肠组(80.43%),差异有统计学意义(P<0.05)。结论足跟部出现软组织缺损状况患者治疗中,足底内侧皮瓣修复可进一步促进患者关节功能及感觉恢复,提高其皮瓣成活率及外观满意度,且术中出血量更低,用时更短,临床疗效优于腓肠神经营养血管皮瓣。Objective To compare the clinical efficacy of medial plantar flap and sural neurovascular flap in the repair of heel soft tissue defect.Methods A total of 92 patients with soft tissue defect of heel admitted to the First Hospital of Yulin from January 2020 to January 2024 were retrospectively selected,and they were divided into the plantar group(n=46)and the sural group(n=46)according to the different repair flaps.The medial plantar flap was selected in the plantar group,and the sural neurovascular flap was selected in the sural group.The surgical indicators(complete flap survival rate,intraoperative blood loss,time of flap resection and transplantation),the American Orthopaedic Foot and Ankle Society(AOFAS)ankle-hindfoot score before operation and 3 months after operation,the British Medical Research Council(BMRC)sensory function classification and flap appearance satisfaction 3 months after operation were compared between the two groups.Results The complete survival rate of the flap in the plantar group was 97.83%,which was higher than that in the sural group(82.61%),the intraoperative blood loss in the plantar group was(101.84±1.69)mL,which was lower than that in the sural group[(104.37±2.08)mL],the time of flap resection and transplantation was(61.53±5.52)min,which was shorter than that in the sural group[(65.68±5.21)min],and the differences were statistically significant(P<0.05).At 3 months after operation,the AOFAS ankle-hindfoot scores of the two groups were higher than those before operation,and the AOFAS ankle-hindfoot score of the plantar group was(84.92±5.14)points,which was higher than that of the sural group[(79.63±5.02)points],the differences were statistically significant(P<0.05).The postoperative BMRC sensory function classification of the plantar group was significantly better than that of the sural group,and the difference was statistically significant(P<0.05).The postoperative flap appearance satisfaction of the plantar group was 95.65%,which was higher than that of the sural group(80.43%

关 键 词：外科皮瓣 足跟部软组织缺损 修复 足底内侧皮瓣 腓肠神经营养血管皮瓣 

分 类 号：R658.3[医药卫生—外科学]