微型外固定架联合前臂骨间背皮瓣修复重度虎口挛缩的疗效观察

doi:10.3969/j.issn.1005-6483.2019.05.022

摘要/Abstract

摘要： 目的:分析微型外固定架联合前臂骨间背皮瓣修复重度虎口挛缩的临床疗效。方法:重度虎口挛缩病人42例，将42例病人分为两组，对照组采用微型外固定架联合桡动脉鼻烟窝上行穿支逆行皮瓣修复治疗，研究组实施微型外固定架联合前臂骨间背皮瓣修复治疗。比较两组病人手术后临床疗效和并发症情况，并对两组病人手术前后虎口角及虎口宽度变化和视觉模拟评分法（VAS）疼痛评分情况、手术处皮肤质量情况进行对比，并记录病人术前及术后患侧虎口区的图片。结果:术前两组病人VAS疼痛评分比较差异无统计学意义，术后研究组平均为（1.3±0.8）分，对照组为（2.5±0.8）分；研究组的治疗有效率为85.7%，对照组为76.2%；研究组的并发率为28.6%，对照组为66.7%；术后研究组的生活质量高于对照组。以上指标两组比较差异有统计学意义（P<0.05）。结论:微型外固定架联合前臂骨间背皮瓣修复重度虎口挛缩具有良好的治疗效果，可减少术后并发症的产生，修复虎口角度及虎口宽度，降低术后疼痛感。

关键词: 外固定架, 骨间背皮瓣, 虎口挛缩

Abstract: Objective:To explore the therapeutic effect of microexternal fixation combined with forearm interosseous dorsal skin flap for the repair of severe tiger contracture.Methods:Fortytwo patients with severe tiger mouth contracture were divided into two groups by random number expression.The control group was treated with miniature external fixator combined with retrograde radial artery snuff socket perforator flap.The study group was treated with miniature external fixator.Repair of forearm interosseous dorsal skin flap.The clinical efficacy and complications were observed and compared between the two groups.The changes of the width of the tiger mouth and the width of the tiger mouth before and after operation were compared with the visual analogue scale（VAS）pain score and the skin quality of the operation site.Results:There was no difference in VAS pain score between the two groups before operation.The average VAS pain score of study group after surgery was（1.3±0.8），while the score of control group was（2.5±0.8）（P<0.05）.The effective rate of the study group was 85.7%，the control group was 76.2%；the concurrent rate of the study group was 28.6%，the control group was 66.7%；the quality of life of the study group was higher than that of the control group（all P<0.05）.Conclusion:Mini external fixator combined forearm interosseous dorsal skin flap to repair severe contracture has good treatment effect，not only can reduce the postoperative complications，can effectively repair in escaping angle and tucks width and reduce postoperative pain of patients，has wide application prospect，is worth further promotion and application in clinic.

Key words: micro external fixator, interosseous dorsal flap, tiger contracture

郝光亮, 张强, 谷铭勇, 张贵春, 张永先, 曹学成, 蔡锦方. 微型外固定架联合前臂骨间背皮瓣修复重度虎口挛缩的疗效观察[J]. 临床外科杂志, 2019, 27(5): 429-432.

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