不同供血方式小腿后外侧带蒂皮瓣修复足踝部皮肤软组织缺损效果研究.docVIP

不同供血方式的小腿后外侧带蒂皮瓣修复足踝部皮肤软组织缺损效果研究 　　[摘要]目的：探讨选择不同供血方式小腿后外侧带蒂皮瓣修复足踝部皮肤软组织缺损的临床效果。方法：选取2013年5月至2016年1月126例足踝部皮肤软组织缺损患者为研究对象，按入组顺序随机分为2组，每组63例。对照组予腓肠神经营养血管皮瓣修复，研究组采用腓动脉穿支蒂腓肠神经营养血管皮瓣。观察术后供区成活情况、并发症发生率、供区穿支收缩期峰值流速（Peak systolic flow velocity，PSV）和住院时间等指标变化情况。结果：对照组并发症发生率为39.68%、皮瓣成活率为96.83%，研究组并发症发生率为41.27%、皮瓣成活率为100.00%，组间差异无统计学意义（P0.05）；研究组在皮瓣长度、皮瓣宽度、皮瓣长宽比、皮瓣面积、住院天数、手术次数上显著优于对照组（P0.05）；两组术后3d、7d、14d、30d、3个月PSV水平较术前显著升高（P0.05）。结论：不同供血方式小腿后外侧带蒂皮瓣修复足踝部皮肤软组织缺损各有优缺点，要结合患者病情、年龄、皮瓣大小及功能需求等综合考虑。 　　[关键词]供血方式；小腿后外侧带蒂皮瓣；足踝；软组织缺损 　　[中图分类号]R622 [文献标志码]A [文章编号]1008-6455（2017）10-0043-04 　　Abstract： Objective To investigate the choice of different blood supply of the posterior lateral leg with the clinical effect of ankle skin flap to repair soft tissue defect. Methods 126 patients with defect of foot and ankle soft tissue from May 2013 to January 2016 were selected as the research object， and they were divided into control group and study group. The control group patients were treated with sural neurovascular flap， the study group patients were treated with peroneal artery perforator pedicled sural neurovascular flap. Donor site survival， complication rate， peak value of perforator peak velocity （PSV） and hospitalization time of two group patients were compared， after treated. Results The complication rate of control group was 39.68%， the survival rate was 96.83%. The complication rate of the study group was 41.27%， and the flap survival rate was 100%， there was no significant difference between the two groups（P0.05）. The flap length， flap width， flap length width ratio， flap area， length of stay and number of operations in the study group were significantly better than those in the control group（P0.05）. The PSV of 3d， 7d， 14d， 30d and 3 months after operation in two groups were significantly higher than those before operation（P0.05）. Conclusion The different blood supply of the posterior lateral leg with foot and ankle skin flap repair of soft tissue defects have advantages and