游离髂腹股沟皮瓣移植治疗手部软组织缺损的疗效研究  

Free ilioinguinal flap transplantation in the treatment of hand soft tissue defect

作　　者：马刚[1] 官常和 万红林[1] 郑雪钢 王永亮[1] Ma Gang;Guan Changhe;Wan Honglin;Zheng Xuegang;Wang Yongliang(Deparatment of Orthopedics,Pangang Group General Hospital,Panzhihua,Sichuan Province 617000,China)

机构地区：[1]攀钢集团总医院骨科,四川攀枝花617000

出　　处：《创伤外科杂志》2025年第3期216-220,共5页Journal of Traumatic Surgery

基　　金：四川省医学会伤口疾病(泰阁)专项科研课题(2022TG28)。

摘　　要：目的探究游离髂腹股沟皮瓣移植治疗手部软组织缺损的疗效。方法回顾性分析2021年1月—2023年12月在四川省攀钢集团总医院骨科就诊的30例手部软组织缺损患者临床资料,其中男性18例,女性12例;年龄36~62岁,平均50.4岁;合并创面感染13例;碾压伤7例,重物砸压伤14例,其他9例;手背部20例,手掌部10例;软组织缺损范围4.0 cm×3.0 cm~6.0 cm×8.0 cm。患者均接受髂腹股沟皮瓣行组织缺损重建治疗,依据指端植皮的选择与晚期疗效评价治疗的有效性与安全性,并分别采用手部功能(DASH)量表和上肢断肢再植功能评定试用标准评估术后3、6、12个月患者手部功能以及上肢功能。结果30例患者皮瓣均成活,成活率为100.0%。患者手术完成后进行为期12个月的随访,所有患者皮瓣外观恢复较好,质地较软。术后经评估显效12例,有效18例,治疗有效率为100.0%。患者术后3、6、12个月DASH评分30~39分分别有0例、12例、18例,40~49分分别有2例、6例、10例,50~59分分别有3例、6例、2例,60~69分分别有6例、6例、0例,≥70分分别有19例、0例、0例。术后6、12个月的手部功能评分情况均优于术后3个月(P<0.05)。术后3、6、12个月,患者上肢功能总分分别为(42.54±3.18)分、(63.08±5.15)分、(74.07±5.49)分,手部功能总分在时间点比较差异有统计学意义(P<0.05)。患者随访期内均未出现血管危象、皮肤脱落以及功能障碍等情况。结论游离髂腹股沟皮瓣修复治疗手部软组织缺损有效且安全,能促进患者手部功能以及上肢功能的恢复。Objective To explore the effect of free ilioinguinal flap transplantation in the treatment of soft tissue defect of hand.Methods This retrospective analysis was conducted on 30 patients with hand soft tissue defects admitted to Deparatment of Orthopedics of Pangang Group General Hospital from Jan.2021 to Dec.2023,including 18 males and 12 females aged 36-62 Deparatment of Orthopedics(mean 50.4)years.Among them,13 patients combined with wound infection;7 cases were crushed by car accidents,14 by heavy objects,and 9 others;20 injured the back of the hand and 10 the palm.Soft tissue defects ranged from 4.0 cm×3.0 cm to 6.0 cm×8.0 cm.All patients received ilioinguinal flap for tissue defect reconstruction.The efficacy and safety of this technique were evaluated.The hand and upper limb functional recovery were assessed by the Disabilities of the Arm,Shoulder and Hand(DASH)scale,and the tentative criteria for upper limb function evaluation by the Society of Hand Surgery,Chinese Medical Association at 3,6 and 12 months after surgery.Results The flap survived in all the cases(100.0%).Patients were followed up for 12 months,which reported good appearance and soft texture of the skin flaps.After surgery,12 cases had significantly effective results and 18 effective results,and the effective rate of surgery was 100.0%.At 3,6 and 12 months after surgery,0,12 and 18 patients had DASH scores of 30-39;2,6 and 10 patients had DASH scores of 40-49;3,6 and 2 patients had DASH scores of 50-59;6,6 and 0 patients had DASH scores of 60-69;19,0,and 0 patients had DASH scores≥70,respectively.The DASH scores at 6 and 12 months were much lower than those at 3 months(P<0.05).At 3,6 and 12 months after surgery,the total score of the upper limb was 42.54±3.18,63.08±5.15 and 74.07±5.49,revealing significant differences between each time point(P<0.05).During the follow-up period,no vascular crises,skin shedding or dysfunction was reported.Conclusion Free ilioinguinal flap is effective and safe in the treatment of hand tissue defects,whic

关 键 词：软组织缺损 手部 髂腹股沟皮瓣 皮瓣移植 疗效 肢体功能 

分 类 号：R658.2[医药卫生—外科学]