改良指背筋膜蒂逆行岛状皮瓣修复指端皮肤缺损的临床应用研究-手外科专业论文.docx

中文 中文摘要 PAGE PAGE 10 关键词 筋膜蒂皮瓣；辅助血管吻合；修复 广州 广州医科大学硕士学位论文 第二部分 改良指背筋膜蒂逆行岛状皮瓣与传统指背筋膜蒂逆行岛状 皮瓣修复指端皮肤缺损的近期与远期疗效对比分析 目的 比较改良指背筋膜蒂逆行岛状皮瓣与传统指背筋膜蒂逆行岛状皮瓣修复指 端皮肤缺损的近期与远期疗效。 方法 选取 2008 年 1 月至 2012 年 4 月于我院行指背筋膜蒂逆行岛状皮瓣修复手指 末节皮肤缺损病例 86 例作为对照组，及行改良指背筋膜蒂逆行岛状皮瓣修复手 指末节皮肤缺损病例 35 例作为观察组，共 121 例。对衡量两组皮瓣的近期疗效 的观察指标：（术后 4h、24h、48h、72h、7d）皮瓣的颜色、肿胀、皮温、返流 和衡量两组皮瓣的远期疗效的观察指标：（术后 9 个月）皮瓣的颜色、外观、质 地、感觉及皮瓣成活率进行比较。 结果 1.两组近期疗效比较：与对照组相比，观察组术后 24 小时、48 小时、72 小时和 7 天皮肤颜色红润、皮温正常、正常或轻度肿胀、返流正常的比例均明显 升高，P＜0.05，差异有统计学意义。2.两组远期疗效比较：与对照组相比，观 察组远期疗效中皮肤红润、外观饱满、质地柔软的比例均明显升高，P＜0.05， 差异有统计学意义。两组皮瓣成活率比较：与对照组相比（89.5%），观察组皮 瓣成活率有所升高（100.0%），但 P0.05，差异没有统计学意义。 结论 改良指背筋膜蒂逆行岛状皮瓣比传统指背筋膜蒂逆行岛状皮瓣的近期与远 期疗效均有明显改善。 关键词 筋膜蒂皮瓣；辅助血管吻合；修复；疗效 英文 英文摘要 The clinical research of the repair of fingertip defects with the modified retrograde dorsal fasciocutaneous flap Postgraduate:Yu Shaoxiao Supervisor:Prof.Zhang zhenwei Major:Hand surgery ABSTRACT Part Ⅰ The clinical efficacy analysis of the repair of fingertip defects with the modified retrograde dorsal fasciocutaneous flapAbstract Objective: To study the efficacy and clinical analysis of the repair of fingertip defects with the modified retrograde dorsal fasciocutaneous flap. Methods: The dorsal vein with the length of 1.0~2.0cm was reserved from the proximal flap when the dorsal fasciocutaneous flap was cut. After the cutting of the flap, loosen the tourniquet, salt water temperature, local application of papaverine for spasmolysis, the flap blood supply and reflux were observed and judged. If the flap blood supply was insufficient, the venous artery flap would be formatted by the communication of flap dorsal vein with arterial stump (10 cases). If the flap vein-reflux disorders occured, the reflux would be improved by the communication of the flap dorsal vein with subcutaneous vein of the receive area(12 cases). If the flap blood supply and reflux was balanced basically, the vascular anastomosis would be not necessary(13 cases). Result: The flap was used to repair skin de