两种皮瓣修复术治疗手外伤软组织缺损的临床对比研究.docVIP

两种皮瓣修复术治疗手外伤软组织缺损的临床对比研究 　　[摘要] 目的 对比胸腹带蒂皮瓣修复术和穿支皮瓣修?褪踔瘟剖滞馍巳碜橹?缺损的临床疗效。 方法 研究对象选自我院2014年5月～2016年12月收治的68例手外伤软组织缺损患者，采取随机数字表将其分成两组，每组34例。观察组采用穿支皮瓣修复术治疗，对照组采用胸腹带蒂皮瓣修复术治疗，对比两组手术疗效及并发症发生情况、手术前后血清白细胞介素（IL）-6、IL-8、肿瘤坏死因子（TNF）-α水平变化情况。 结果 观察组治疗后优良率为85.29%，与对照组的47.06%相比明显上升（P0.05）。 结论 在手外伤软组织缺损的修复治疗方面，穿支皮瓣修复术相对于胸腹带蒂皮瓣修复术疗效更为确切，其能有效抑制炎性反应，加快创面愈合。 　　[关键词] 穿支皮瓣修复术；胸腹带蒂皮瓣修复术；手外伤软组织缺损；炎症反应 　　[中图分类号] R658.2 [文献标识码] B [文章编号] 1673-9701（2017）06-0057-04 　　[Abstract] Objective To compare the clinical curative effects of chest abdominal pedicled flap repair and perforator flap repair in the treatment of traumatic soft tissue defect. Methods The subjects of this study were selected from 68 cases of hand injury of soft tissue defect patients admitted in our hospital from May 2014 to December 2016 with the method of random number table， who were divided into two groups， each group with 34 cases. The observation group adopted perforator flap repair treatment， while the control group was treated with thoracic and abdominal pedicle flap repair. The surgical efficacy and complications of the two groups were compared， and the changes of serum interleukin（IL）-6， IL-8， tumor necrosis factor（TNF）-α levels before and after operation were also compared. Results The excellent and good rate of the observation group was 85.29%， which increased significantly compared with 47.06% of the control group（P0.05）. Conclusion In the treatment of hand trauma soft tissue defect， compared with chest abdominal pedicled flap repair， the repair of perforator flap has more accurate curative effect and can effectively inhibit inflammation and accelerate wound healing. 　　[Key words] Repair of perforator flap； Repair of abdominal pedicle flap of chest； Soft tissue defect of hand injury； Inflammatory reaction 　　手外伤常伴有软组织缺损，并可累及骨关节、神经、血管、肌腱等。手外伤软组织缺损的修复过程复杂，若得不到有效且及时的修复，易引起手部功能恢复不健全，乃至引发运动功能永久性缺损，严重影响患者的生活、工作以及心理，故选择有效的修复方法尤为重要[1，2]。目前临床对于手外伤软组织缺损主要采取皮瓣修复治疗，皮瓣修复能一期覆盖创面，最大限度促使手部外形与功能得以恢复，保护肢体组织，从而提高生活质量[3，4]。但在行皮瓣修复