游离带指背神经环指尺侧指动脉皮瓣修复指腹缺损研究.docVIP

游离带指背神经环指尺侧指动脉皮瓣修复指腹缺损研究 　　【摘要】 目的：研究游离带指背神经环指尺侧指动脉皮瓣修复指腹缺损手术方法与带蒂皮瓣修整术的手术效果比较。方法：选择2013年8月-2014年8月来本院进行指腹缺损组织修复的患者32例，经患者同意，分为A组16例和B组16例。A组采用游离带指背神经环指尺侧指动脉皮瓣修复，B组采用同指体的指动脉皮瓣、指背筋膜皮瓣、临指皮瓣等方法进行修复。比较两组患者的植活率和满意度。结果：A组总有效率81.25%，B组总有效率68.75%。结论：游离带指背神经环指尺侧指动脉皮瓣修复指腹缺损更适合指腹组织缺损的修复。 　　【关键词】 游离； 指动脉； 指背神经； 指腹缺损； 环指尺侧； 皮瓣修复 　　Study of Skin Flap Repair for Pulp Defect at the Free Zone Dorsal Digital Nerves of Ulnar Ring Finger Artery/AI Ming-yang， HUANG Su-hua， ZHOU Jia-feng， et al.//Medical Innovation of China，2015，12（10）：056-059 　　【Abstract】 Objective：To research the difference in clinical effect between skin flap repair for pulp defect at the free dorsal nerve ring finger ulnar artery and pedicled skin flap repair.Method：32 patients who came to our hospital for repair of pulp defect from August 2013 to August 2014 were chosen with their approval.They were divided into group A and group B， 16 cases in each group.Patients in the group A were given skin flap repair for pulp defect at the free zone dorsal digital nerves of ulnar ring finger artery while， and those in the group B were repaired by digital artery flap， dorsal fascial flap， pro finger flap and so on.Engraftment rate and degree of satisfaction of the two groups were compared.Result：The total effective rate of the group A was 81.25%， while that of the group B was 68.75%.Conclusion：Skin flap repair for pulp defect at the free zone dorsal digital nerves of ulnar ring finger artery is more suitable for finger pulp tissue defect. 　　【Key words】 Free zone； Digital artery； Dorsal digital nerves； Pulp defect； Ulnar ring finger； Skin flap repair 　　First-author’s address：Songgang People’s Hospital of Baoan， Shenzhen 518000， China 　　doi：10.3969/j.issn.1674-4985.2015.10.019 　　指腹是在外伤中较容易出现缺损伤的部位，本院几乎每天都会收治指腹缺损伤患者。指腹损伤需要进行皮瓣修复，而指部关节密集，指腹部位如果采用临近皮瓣，则发生蒂部跨关节的情况，且因为指背部位的神经与血管并不并行，变异性大，血供不确切，而且切口瘢痕长，带蒂皮瓣蒂部易扭转等情况，所以，采用带蒂皮瓣修复指腹组织缺损，虽可成活，但质量不高，且指腹感觉恢复较差，切口较长，多跨关节，术后功能影响明显。本文研究使用指背游离皮瓣进行手术，其对血管吻合和神经吻合的支持较好，通过调整手术设计和护理方案，可以保证指腹游