不同方法治疗全手脱套伤效果比较.docVIP

不同方法治疗全手脱套伤的效果比较 　　[摘要] 目的 探讨双侧足趾联合一期修复在全手脱套伤中的应用效果。 方法 选取我院2010年1月～2015年1月收治的10例全手脱套伤患者，行双侧足?[趾腓侧皮瓣加第4趾甲皮瓣瓦合双手指，带双足背皮瓣覆盖手背及股前外侧皮瓣覆盖手掌创面治疗（A组）；另选取我院同期采用传统腹部袋状皮瓣修复的8例患者作为对照组（B组），比较两组患手感觉恢复情况，总主动活动度（ROM）、握力、静态两点辨别觉（s2PD）和返回正常工作时间。 结果 A组10例患者，成活9例，坏死1例，其中1例术后24 h内发生静脉危象，给予二期皮瓣修复后痊愈，皮瓣修复后治愈，再造手指存活，但外观较回植者差。患者均获得随访，时间6～24个月，指端两点分辨觉为4.8 mm。B组8例患者中成活7例，坏死1例，A组患者术后手指感觉恢复和主动活动度均明显优于B组，差异有统计学意义（P0.05）；A组患者返回正常工作岗位的时间明显短于B组，差异有统计学意义（P0.05）。 结论 双侧足趾联合一期修复可恢复缺损手指的外形及功能，疗效满意，是多个手指脱套伤治疗的较好选择。 　　[关键词] 指损伤；手部脱套伤；趾关节；一期修复；移植 　　[中图分类号] R622 [文献标识码] A [文章编号] 1674-4721（2016）05（a）-0019-05 　　Comparison the effects of different methods in treating complete hand skin tissue of degloving injury 　　DING De-wei1 WANG Hong-cai1 WANG Li-hua2 WANG Chun-mei3 　　1.Department of Foot and Hand Microsurgery，Dongguan Renkang Hospital in Guangdong Province，Dongguan 523952，China；2.Department of Nursing，Dongguan Renkang Hospital in Guangdong Province，Dongguan 523952，China；3.Plastic and Cosmetic Center in Dongguan Renkang Hospital，Guangdong Province，Dongguan 523952，China 　　[Abstract] Objective To explore the effects of bilateral toes combined with primary repair in treating complete hand skin tissue of degloving injury. Methods 10 hands skin tissue of degloving injury patients from January 2010 to January 2015 of our hospital were given double parapodum toe phil side flap with the fourth toenail skin flap in both hands，with double dorsalis pedis flap to cover the back of hand and femoral anterolateral flap covering of the palm of hands（group A）.8 cases were given traditional abdominal pocket flap repair in our hospital at the same term were selected as control group（group B）.Hand feeling recovery situation，active total range of motion（ROM），grip strength，static two-point discrimination（s2PD），and time of going back to work between two groups were compared. Results 10 patients in group A，with 9 cases survived and 1 necrosis；1 cases appeared venous crisis within 24 h after operation and recovered after g