| 白 杰,黄省利,张海平,康光明,李 鹏.股前外侧穿支皮瓣与胸腹带蒂皮瓣对手外伤组织缺损修复的应用效果及对创面愈合程度的影响[J].,2021,(19):3704-3708 |
| 股前外侧穿支皮瓣与胸腹带蒂皮瓣对手外伤组织缺损修复的应用效果及对创面愈合程度的影响 |
| Application Effect of Anterolateral Thigh Perforator Flap and Thoracic-abdominal Pedicled Flap in Repairing Hand Traumatic Tissue Defect and Its Influence on Wound Healing |
| 投稿时间：2021-05-07 修订日期：2021-05-28 |
| DOI：10.13241/j.cnki.pmb.2021.19.021 |
| 中文关键词: 股前外侧穿支皮瓣 胸腹带蒂皮瓣 手外伤组织缺损 创面愈合程度 皮瓣成活率 皮瓣危象 |
| 英文关键词: Anterolateral thigh perforator flap Thoracoabdominal pedicle flap Tissue defect of hand trauma The degree of wound healing The survival rate of skin flap Flap crisis |
| 基金项目:陕西省科技攻关项目（2018SF-046） |
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| 中文摘要: |
| 摘要 目的：探讨股前外侧穿支皮瓣与胸腹带蒂皮瓣对手外伤组织缺损修复的应用效果及对创面愈合程度的影响。方法：选取我院2018年12月到2020年12月共收治的119例手外伤组织缺损患者作为研究对象，随机分为2组，分别为对照组（n=59，应用胸腹带蒂皮瓣修复术）和观察组（n=60，应用股前外侧穿支皮瓣修复术）。对比两组患者治疗优良率，对比两组患者治疗前后手部创面面积、创面愈合程度以及组织愈合时间，对比两组患者治疗后的Jamar握力、TAM和DASH评分情况，对比两组患者的皮瓣成活率、皮瓣危象率和血管吻合时间。结果：通过对比两组患者治疗优良率发现，观察组患者优的人数为21例、良为35例，优良率为93.33%，对照组患者优的人数为16例，良为30例，优良率为77.97%，观察组高于对照组（P＜0.05）；治疗后，与对照组相比，观察组患者的手部创面面积、组织愈合时间和DASH评分显著减少，创面愈合程度以及TAM与Jamar握力显著增加（P＜0.05）；通过对比两组患者的皮瓣成活率、术后皮瓣危象率以及血管吻合时间发现，两组患者的术后皮瓣危象率、血管吻合时间对比无明显差异（P＞0.05），两组患者的术后皮瓣成活率对比差异显著，观察组明显高于对照组（P＜0.05）。结论：对手外伤组织缺损患者应用股前外侧穿支皮瓣与胸腹带蒂皮瓣修复术均具有明显的修复效果，但是应用股前外侧穿支皮瓣能够提升治疗效果，提升患者创面愈合程度减少愈合时间，提升患者手部运动情况，提升术后皮瓣成活率，值得临床应用推广。 |
| 英文摘要: |
| ABSTRACT Objective: To explore the effect of anterolateral thigh perforator flap and thoracoabdominal pedicled flap on the repair of hand traumatic tissue defect and the effect on wound healing. Methods: A total of 119 patients with hand trauma tissue defects admitted in our hospital from December 2018 to December 2020 were selected as the research objects, and they were randomly divided into 2 groups. They were the control group (n=59, using thoracic-abdominal pedicle flap repair) and the observation group (n=60, using anterolateral thigh perforator flap repair). The excellent and good rates of the two groups were compared. The hand wound area, wound healing degree and tissue healing time before and after treatment were compared between the two groups. The scores of Jamar grip strength, TAM and dash were compared between the two groups. The flap survival rate, flap crisis rate and vascular anastomosis time of the two groups were compared. Results: By comparing the excellent and good rate of the two groups, it was found that the number of excellent patients in the observation group was 21 cases, the number of good patients was 35 cases, the excellent and good rate was 93.33%, the number of excellent patients in the control group was 16 cases, the number of good patients was 30 cases, the excellent and good rate was 77.97%, the observation group was higher than the control group(P<0.05); After treatment, compared with the control group, the hand wound area, tissue healing time and DASH score of the observation group were significantly reduced, and the degree of wound healing and TAM and Jamar grip strength were significantly increased(P<0.05). By comparing the flap survival rate, postoperative flap crisis rate and vascular anastomosis time of the two groups, it was found that there was no significant difference in the flap crisis rate and vascular anastomosis time of the two groups (P>0.05), but the flap survival rate of the two groups was significantly different, and the observation group was significantly higher than the control group (P< 0.05). Conclusion: The application of anterolateral thigh perforator flap and thoracoabdominal pedicled skin flap in the repair of hand trauma tissue defect has obvious repair effect, but the application of anterolateral thigh perforator flap can improve the treatment effect, improve the wound healing degree, reduce the healing time, improve the hand movement of patients, and improve the survival rate of postoperative flap, which is worthy of clinical application and promotion. |
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