| 欧阳容兰,刘江涛,王一勇,张 勇,刘丁井.胫后动脉穿支皮瓣与吻合皮下静脉的带蒂皮瓣对四肢皮肤及软组织缺损的应用效果对比[J].,2024,(12):2284-2287 |
| 胫后动脉穿支皮瓣与吻合皮下静脉的带蒂皮瓣对四肢皮肤及软组织缺损的应用效果对比 |
| Comparison of the Application Effects of Posterior Tibial Artery Perforator Flap and Pedicle Skin Flap Anastomosed with Subcutaneous Vein on Limb Skin and Soft Tissue Defects |
| 投稿时间：2023-11-06 修订日期：2023-11-29 |
| DOI：10.13241/j.cnki.pmb.2024.12.015 |
| 中文关键词: 胫后动脉穿支皮瓣 吻合皮下静脉的带蒂皮瓣 四肢皮肤 软组织缺损 |
| 英文关键词: Posterior tibial artery perforator flap Pedicled skin flap anastomosing subcutaneous veins Skin of limbs Soft tissue defects |
| 基金项目:福建省自然科学基金项目（2023J01241） |
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| 中文摘要: |
| 摘要 目的：对比胫后动脉穿支皮瓣与吻合皮下静脉的带蒂皮瓣对四肢皮肤及软组织缺损的应用效果。方法：选取2017年3月到2022年3月68例四肢皮肤及软组织缺损患者，各组均为34例。所有患者均采取皮瓣修复手术，对照组患者采取胫后动脉穿支皮瓣治疗，观察组采取吻合皮下静脉的带蒂皮瓣治疗。对比临床疗效，术中出血量、等指标，最后对两组患者进行1年随访，对比其并发症发生率及1年内术后二次修复情况。结果：观察组治疗总有效率较对照组高（P＜0.05）；两组患者术中出血量、手术时间、术后VAS评分对比无明显差异，观察组住院时间、创面愈合时间明显低于对照组（P＜0.05）；两组患者术后感觉功能恢复S3级、S2级、S1级、S0级人数对比无明显差异（P＞0.05），观察组术后感觉功能恢复S4级人数明显高于对照组（P＜0.05）；与对照组相比，观察组出现的并发症发生率、术后二次修复率低（P＜0.05）。结论：吻合皮下静脉的带蒂皮瓣修复与胫后动脉穿支皮瓣修复术相比可进一步改善疗效，缩短住院时间，有利于创面愈合、感觉功能恢复，降低远期并发症发生率及术后二次修复率，值得临床应用推广。 |
| 英文摘要: |
| ABSTRACT Objective: To compare the application effect of the posterior tibial artery perforator flap and the pedicled skin flap anastomosing subcutaneous veins on skin and soft tissue defects in the limbs. Methods: 68 patients with limb skin and soft tissue defects admitted to our hospital from March 2017 to March 2022 were selected as the study subjects, with 34 cases in each group. All patients underwent flap repair surgery, while the matched group received treatment with the posterior tibial artery perforator flap, while the observation group received treatment with a pedicle skin flap anastomosing the subcutaneous vein. Compare the clinical efficacy, intraoperative bleeding volume, surgical time, hospital stay, wound healing time, postoperative pain level, and sensory function recovery between the two groups of patients. Finally, conduct a one-year follow-up of the two groups of patients to compare their incidence of complications and secondary repair within one year. Results: The total response rate was higher in the observation group than in the matched group(P<0.05); There was no difference in intraoperative bleeding volume, surgical time, and postoperative VAS score between the two groups of patients. The observation group had lower hospital stay and wound healing time than the matched group(P<0.05); There was no difference in the number of patients with postoperative sensory function recovery at S3, S2, S1, and S0 levels between the two groups (P>0.05). The number of patients with postoperative sensory function recovery at S4 level in the observation group was higher than that in the matched group(P<0.05); The rate of postoperative complications and the rate of postoperative secondary repair in the observation group were significantly lower than that in the matched group (P<0.05). Conclusion: Compared with the repair of skin and soft tissue defects in the limbs using the posterior tibial artery perforator flap, the repair of pedicle skin flap with subcutaneous vein anastomosis can further improve the treatment effect, shorten the hospitalization time of patients, promote wound healing, improve postoperative sensory function recovery level, reduce the incidence of long-term complications and secondary repair rate, and is worthy of clinical application and promotion. |
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