动脉化静脉皮瓣修复手部软组织缺损可行性研究.docVIP

动脉化静脉皮瓣修复手部软组织缺损可行性研究 　　[摘要]目的 探讨动脉化静脉皮瓣修复手部软组织缺损的可行性。方法 选取2014年3月～2016年3月本院接诊的60例手部软组织缺损患者作为研究对象，给予动脉化静脉皮瓣修复术治疗，监测皮瓣颜色、血液回流情况及毛细血管反应，并及时记录患者手部弯曲的恢复情况。结果 以弯曲0°～180°为标准，动脉化静脉皮瓣修复手术后，在手术3周后去除石膏固定，手部可自由活动，可进行手部锻炼。在手术后第7周，大部分患者功能恢复良好；在手术3个月及6个月后，手部功能恢复良好，具有明显的对比差异（P0.05）。皮瓣颜色及外观逐渐恢复正常，且血流畅通。结论 动脉化静脉皮瓣修复手部软组织缺损的效果较好，在手术6个月后，手部功能基本恢复，此方法对于手部软组织损伤修补具有较高的可行性。 　　[关键词]动脉化静脉皮瓣；手部软组织；修复缺损部位 　　[中图分类号] R658.2 [文献标识码] A [文章编号] 1674-4721（2016）07（b）-0028-03 　　[Abstract]Objective To explore the feasibility of arterialized venous skin flap for repairing soft tissue defect of the hand.Methods 60 cases of hand soft tissue defect from March 2014 to March 2016 in our hospital were selected as the research group，and arterialized venous skin flap repair surgery was given.The color of skin flap，blood reflux and capillary reaction were detected，and the recovery situation of hand bending of patient was recorded.Results The bending of 0°-180° was selected as the standard.After the operation，the removal of plaster was fixed and the hand can be freely movable，and the hand exercise can be carried out after 3 weeks.In the seventh week after surgery，most of the patients recovered well，and the hand function recovered well after 3 months and 6 months，there was significant difference （P0.05）.The color and appearance of the skin flap gradually returned to normal，and the blood flow was smoothed.Conclusion The effect of arterialized venous skin flap in repairing soft tissue defects of the hand is good.After 6 months of operation，the function of the hand is basically restored，this method is feasible to repair the soft tissue injury of the hand. 　　[Key words] Arterialized venous skin flap；Hand soft tissue；Repairing of defect site 　　目前，手部软组织损伤在手伤中占有较大比例，严重影响患者的生活自理能力[1]。近年来，医务工作者对手部软组织损伤的治疗也有相应的研究[2]，动脉化静脉皮瓣就是新兴的治疗手部软组织损伤的常用方法[3-4]。本研究选取本院的手部软组织缺损患者作为研究对象，采用动脉化静脉皮瓣修复术，旨在探讨其可行性。 　　1材料与方法 　　1.1一般资料 　　选取2014年3月～2016年3月本院接诊的60例手部软组织缺损患者作为研究对象，其中男性39例，女性21例；年龄18～55岁；受伤原因：挤压伤30例，螺丝锯削伤17例，切割伤13例。致伤部位：食指背侧