皮瓣修复在手部组织缺损治疗中的应用

胡明龙+易秀珍+叶润轩

[摘要] 目的 分析皮瓣修复在手部组织缺损治疗中的应用。 方法 将2010年1月～2016年1月60例手部组织缺损患者，随机分为对照组与实验组，对照组行前臂或胸腹部皮瓣修复，实验组行局部皮瓣修复。观察两组临床疗效。 结果 实验组手术治疗总有效率为93.3%，明显高于对照组的80.0%，差异具有统计学意义（P<0.05）；观察组术后1、2周时的VAS评分，明显优于对照组，差异具有统计学意义（P<0.05）。 结论 应用皮瓣修复治疗手部组织缺损效果确切，有利于缓解术后患者疼痛，伤情康复较快，值得推广应用。

[关键词] 手部组织缺损；皮瓣修复；疗效；疼痛

[中图分类号] R658.2 [文献标识码] A [文章编号] 2095-0616（2017）08-216-03

[Abstract] Objective To analyze the application of skin flap repair in treatment of hand tissue defect. Methods 60 patients with hand tissue defect from January 2010 to January 2016 were divided into the control group and the experimental group. The control group was treated with skin flap repair of forearm or chest and abdomen. The experimental group was treated with local skin flap repair. Clinical curative effects of two groups were observed. Results The total effective rate of surgical treatment of the experimental group was 93.3%， higher than that of the control group 80%. The difference was statistically significant （P<0.05）. VAS scores of 1 week and 2 weeks after operation of the experimental group were significantly higher than that of the control group. The difference was statistically significant （P<0.05）. Conclusion Skin flap repair in the treatment of hand tissue defect has acute effect and it is helpful to relieve the postoperative pain patients. Injuries have a rapid rehabilitation， worthy of promotion and application.

[Key words] Hand tissue defect； Skin flap repair； Curative effect； Pain

手部組织缺损多合并骨骼和肌腱外露，患者皮肤组织受创后有较大几率出现感染问题，早期行皮瓣修复处理有利于及时清创，降低创面感染率[1]。随着近年来临床对上肢皮神经和营养血管解剖研究的不断深入，皮瓣修复术开始广泛应用于手部组织缺损临床治疗中并取得了理想效果，术后皮瓣成活率、修复成功率较高，且患者术后并发症发生率低。本研究主要以局部皮瓣修复术为例，选取了2010年1月～2016年1月期间收治的60例手部组织缺损患者为研究对象，探讨皮瓣修复在手部组织缺损治疗中的应用，希望为临床治疗工作提供一定参考。现作如下具体报道。

1 资料与方法

1.1 一般资料

选取我院2010年1月～2016年1月期间收治的60例手部组织缺损患者为本次研究对象，入组病例均为同侧手部拇指软组织缺损。按照随机数字表法将其分为对照组与实验组，每组30例。对照组中男14例，女16例；年龄最小19岁，最大43岁，平均（31.4±2.4）岁；受伤原因：机器绞轧致伤15例，交通事故致伤7例，切割伤6例，烧烫伤2例。……