医学论文-应用带血管蒂皮瓣、肌（皮）瓣治疗下肢皮肤软组织缺损26例分析.docVIP

医学论文-应用带血管蒂皮瓣、肌（皮）瓣治疗下肢皮肤软组织缺损26例分析 【摘要】? 目的：探讨采用带血管蒂皮瓣、肌（皮）瓣修复下肢皮肤软组织缺损、重建功能、再造器官和改善外形的效果。方法：采用带血管蒂皮瓣、肌（皮）瓣，通过局部转移或移位，进行血管、神经吻合，覆盖因创伤造成的下肢软组织缺损。结果：本组共26例患者，一期治愈23例，治愈率88.5%；二期治愈3例，治愈率11.5%，总治愈率100%。结论：由于不同于传统的随意皮瓣，切取范围不受长宽比例限制，手术一次完成。极大可能的修复缺损的皮肤及软组织，保持患肢的长度及功能。 【关键词】? 带血管蒂皮瓣；移植；下肢；软组织缺损 ?Analysis for 26 Cases with Lower Limb Soft Tissue Damage ??? Treated by the Belt Blood Vessel Tippy Petal ??? ZHAO Jun,MA Zhi-peng ??? Hospital of Zhangjiakou Coal Mining Machinary Plant, ??? China National Coal Group Corp,Zhangjiakou,075000,Hebei,China ??? 【ABSTRACT】? Objective:To study the efect of the belt blood vessel tippy petal for repairing skin soft tissue damage,reconstruction function,are born again the organ and the improvement contour.Methods:The belt blood vessel Tippy petal and the myo-skin petal,were used to cover the wound,the inflammation,the tumor excision,the abnormal adjustment and created soft tissue damage through the partial shift or shifting.Results:Among 26 cases,23 patients were cured in the first stage,accounting for 88.5%,3 patients were cured in the second stage,accounting for 11.5%,total cure rate 100%.Conclusion:Because it is different with the traditional optional skin petal,the length and breadth of cuts was limited,surgery was completed one time.The soft tissue damage was repaired excellently,and the length and function were maintained. ??? 【KEY WORDS】? the Belt Blood Vessel Tippy Petal,Transplant,Lower Limb,Soft Tissue Damage ??? 带血管蒂皮瓣、肌（皮）瓣移位术是把带血管蒂的皮瓣、肌（皮）瓣等，通过局部转移或者移位的方法，修复组织缺损、重建功能、再造器官和改善外形。由于不同于传统的随意皮瓣，切取范围不受长宽比例限制，手术一次完成。术后转移的皮瓣、肌（皮）瓣血运丰富，组织愈合快，抗感染能力强，我院自2005.12~2008.8月临床应用下肢带血管蒂皮（肌皮）瓣治疗26例因外伤等原因致下肢皮肤及组织缺损患者，取得了较满意的疗效。 ??? 1? 资料与方法 ??? 1.1? 一般资料 ??? 本组共26例，其中男22例，女4例；年龄最小18岁，最大65岁，平均37.5岁；缺损原因：重物压砸伤12例，车祸伤9例，机器搅伤5例；缺损部位：小腿及踝关节部位18例，足跟部5例，足背、底部及足跟部3例。皮瓣使用：腓肠神经营养血管皮瓣13例，小腿内侧皮瓣6例，股前外侧游离皮瓣5例，股前游离皮瓣2例。术后随访6月至2年。 ??? 1.2? 手术适应证 ??? 1.2.1? 由于人体几乎任何部位皮肤均可形成皮瓣或肌（皮）瓣，这就使人体任何部位创面均可采用临近皮瓣或者肌（皮）瓣移位修复，因此该方法适用范围较广，可用于①因创伤、炎症、肿瘤切除、畸形校正等造成的软组织缺损，有骨、关节、肌腱