改良示指背侧岛状皮瓣一期修复拇指末节缺损的效果评估(1)
【摘要】 目的：研究改良示指背侧岛状皮瓣一期修复拇指末节缺损的效果。方法：选择2017年1月-2020年1月本院收治的40例拇指末节缺损患者作为研究对象，按治疗方式的不同将其分为常规组(予以拇指桡背侧岛状皮瓣修复治疗，选用的是拇指皮瓣)和研究组(予以改良示指背侧岛状皮瓣一期修复治疗，选用的是示指皮瓣)，每组20例。比较两组治疗后的手功能评定(TAM)评分、并发症发生率及皮瓣外观优良率。结果：经过治疗，研究组的TAM评分高于常规组(P<0.05);研究组的并发症发生率低于常规组(P<0.05);研究组的皮瓣外观优良率高于常规组(P<0.05)。结论：利用改良示指背侧岛状皮瓣技术进行一期修复，能帮助拇指末节损伤患者改善手功能，皮瓣外观较好，且并发症相对较少，有利于患者拇指的恢复。
【关键词】 改良示指背侧岛状皮瓣 一期修复 拇指末节缺损 并发症
doi：10.14033/j.cnki.cfmr.2020.27.046 文献标识码 B 文章编号 1674-6805(2020)27-0-02
[Abstract] Objective： To evaluate the effect of one-stage repair of the defect of thumb end segment with the modified island flap of dorsal index finger. Method： From January 2017 to January 2020， 40 patients with thumb end defect in our hospital were selected as the research objects. According to the different treatment methods， they were divided into the routine group (treated with radial dorsal island flap of thumb， selected with thumb flap) and the study group (treated with modified dorsal island flap of dorsal index finger， selected with index finger flap)， 20 cases in each group. The TAM score， complication rate and skin flap appearance of the two groups were compared. Result： After treatment， the TAM score of the study group was higher than that of the routine group (P<0.05); the incidence of complications of the study group was lower than that of the routine group (P<0.05); the fine rate of skin flap appearance in the study group was higher than that of the routine group (P<0.05). Conclusion： Using the improved island flap technique of the dorsal index finger for one-stage repair can help the patients with thumb end segment injury to improve the hand function， the appearance of the flap is better， and the complications are relatively less， which is conducive to the recovery of the thumb.
[Key words] Modified island flap of dorsal index finger One-stage repair Defect of thumb end segment Complications
First-author’s address： Dongguan East Central Hospital， Dongguan 523000， China
拇指末节缺损是临床上最常见的一种手部创伤，会降低患者的手指功能和手部美观，影响患者的生活质量和身心健康。皮瓣修复是治疗拇指末节缺损常用方法，包括拇指桡背侧岛状皮瓣修复、改良示指背侧岛状皮瓣一期修复等，可帮助患者保留拇指长度，重建拇指感觉和外观[1]。拇指桡背侧岛状皮瓣修复选用的是拇指皮瓣，血管蒂短，容易出现供血不足等现象，影响预后。有研究表明，改良示指背侧岛状皮瓣一期修复所选择的示指皮瓣存活率高，对患者手部预后较好[2]。基于此，本次研究将改良示指背侧岛状皮瓣一期修复应用至本院收治的拇指末节缺损患者中，并获得理想效果，具体报告如下。
1 资料与方法
1.1 一般资料
选择2017年1月-2020年1月本院收治的40例拇指末节缺损患者作为研究对象，纳入标准：(1)经临床诊断为拇指末节缺损，且需要进行修复治疗;(2)单手受伤;(3)受伤至手术时间小于5 h。排除标准：(1)依从性极低;(2)皮肤出现严重感染。按治疗方式的不同将其分为常规组和研究组，每组20例。常规组男12例，女8例;年龄19～57岁，平均(41.02±4.69)歲;其中，切割致伤8例，挤压致伤6例，撕脱致伤6例。研究组男11例，女9例;年龄19～57岁，平均(41.87±4.85)岁;其中，切割致伤7例，挤压致伤5例，撕脱致伤8例。两组的基线资料差异无统计学意义(P>0.05)。本次研究已获得伦理委员会的批准。患者了解本次研究，签署知情同意书。, 百拇医药(陈拓 谢燕敏 黄秀云)
【关键词】 改良示指背侧岛状皮瓣 一期修复 拇指末节缺损 并发症
doi：10.14033/j.cnki.cfmr.2020.27.046 文献标识码 B 文章编号 1674-6805(2020)27-0-02
[Abstract] Objective： To evaluate the effect of one-stage repair of the defect of thumb end segment with the modified island flap of dorsal index finger. Method： From January 2017 to January 2020， 40 patients with thumb end defect in our hospital were selected as the research objects. According to the different treatment methods， they were divided into the routine group (treated with radial dorsal island flap of thumb， selected with thumb flap) and the study group (treated with modified dorsal island flap of dorsal index finger， selected with index finger flap)， 20 cases in each group. The TAM score， complication rate and skin flap appearance of the two groups were compared. Result： After treatment， the TAM score of the study group was higher than that of the routine group (P<0.05); the incidence of complications of the study group was lower than that of the routine group (P<0.05); the fine rate of skin flap appearance in the study group was higher than that of the routine group (P<0.05). Conclusion： Using the improved island flap technique of the dorsal index finger for one-stage repair can help the patients with thumb end segment injury to improve the hand function， the appearance of the flap is better， and the complications are relatively less， which is conducive to the recovery of the thumb.
[Key words] Modified island flap of dorsal index finger One-stage repair Defect of thumb end segment Complications
First-author’s address： Dongguan East Central Hospital， Dongguan 523000， China
拇指末节缺损是临床上最常见的一种手部创伤，会降低患者的手指功能和手部美观，影响患者的生活质量和身心健康。皮瓣修复是治疗拇指末节缺损常用方法，包括拇指桡背侧岛状皮瓣修复、改良示指背侧岛状皮瓣一期修复等，可帮助患者保留拇指长度，重建拇指感觉和外观[1]。拇指桡背侧岛状皮瓣修复选用的是拇指皮瓣，血管蒂短，容易出现供血不足等现象，影响预后。有研究表明，改良示指背侧岛状皮瓣一期修复所选择的示指皮瓣存活率高，对患者手部预后较好[2]。基于此，本次研究将改良示指背侧岛状皮瓣一期修复应用至本院收治的拇指末节缺损患者中，并获得理想效果，具体报告如下。
1 资料与方法
1.1 一般资料
选择2017年1月-2020年1月本院收治的40例拇指末节缺损患者作为研究对象，纳入标准：(1)经临床诊断为拇指末节缺损，且需要进行修复治疗;(2)单手受伤;(3)受伤至手术时间小于5 h。排除标准：(1)依从性极低;(2)皮肤出现严重感染。按治疗方式的不同将其分为常规组和研究组，每组20例。常规组男12例，女8例;年龄19～57岁，平均(41.02±4.69)歲;其中，切割致伤8例，挤压致伤6例，撕脱致伤6例。研究组男11例，女9例;年龄19～57岁，平均(41.87±4.85)岁;其中，切割致伤7例，挤压致伤5例，撕脱致伤8例。两组的基线资料差异无统计学意义(P>0.05)。本次研究已获得伦理委员会的批准。患者了解本次研究，签署知情同意书。, 百拇医药(陈拓 谢燕敏 黄秀云)