临床外科杂志 ›› 2024, Vol. 32 ›› Issue (10): 1083-1086.doi: 10.3969/j.issn.1005-6483.2024.10.021

• 论著 • 上一篇    下一篇

显微血管技术联合穿支皮瓣修复手外伤软组织缺损的疗效分析

王帅 许道宏 李磊 石绪才   

  1. 264400 山东省文登整骨医院骨手显微外科(王帅、许道宏、石绪才) ,关节骨科(李磊)
  • 收稿日期:2023-10-27 出版日期:2024-11-07 发布日期:2024-11-07
  • 通讯作者: 石绪才,Email:sxc544848996@163.com

Efficacy analysis of microvascular technique combined with perforating flap to repair soft tissue defects of hand trauma

WANG Shuai,XU Daohong,LI Lei,SHI Xucai   

  1. Department of Joint Orthopedics,Wendeng Osteopathic Hospital,Shandong 264400,China
  • Received:2023-10-27 Online:2024-11-07 Published:2024-11-07

摘要: 目的探讨经显微血管技术联合穿支皮瓣修复术治疗手外伤软组织缺损的疗效。方法 2018年8月~2023年2月我院收治的手外伤软组织缺损病人98例,用随机数字表法将98例病人分为对照组和观察组,每组各49例。对照组采用胸腹带蒂皮瓣修复术治疗,观察组采用经显微血管技术联合穿支皮瓣修复术治疗。比较两组疗效、视觉模拟(VAS)评分、组织病理学评分,治疗前后手指总活动度(TAM)评分、感觉功能分级及生活质量综合评定问卷-74(GQOLI-74)评分。结果 术后6个月,观察组疗效明显高于对照组(95.92%vs79.59%)(P<0.05)。观察组术后3天和7天VAS评分低于对照组,组织病理学评分高于对照组,两组比较差异有统计学意义(P<0.05)。观察组术后6个月TAM评分、感觉功能分级分别为(3.37±0.43)分、(4.17±0.12)级,高于对照组的(2.27±0.26)分、(3.32±0.12)级,两组比较,差异有统计学意义(P<0.05)。观察组术后6个月,心理功能、躯体功能、社会功能和物质功能评分均高于对照组,两组比较差异有统计学意义(P<0.05)。结论经显微血管技术联合穿支皮瓣修复术对手外伤组织损伤病人具有显著疗效,可改善其手感觉及运动功能,减轻疼痛,提高组织愈合程度及生活质量。

关键词: 经显微血管技术; 穿支皮瓣修复术; 手外伤软组织缺损; 手功能

Abstract: Objective To explore the efficacy of microvascular technology combined with perforator flap repair in the treatment of soft tissue defects in hand injuries.Method 98 patients with hand injury soft tissue defects admitted to our hospital from August 2018 to February 2023 were selected as the study subjects.The patients were randomly divided into a control group and an observation group using a random number table method,with 49 cases in each group.The control group was treated with thoracoabdominal pedicle flap repair,while the observation group was treated with microvascular technology combined with perforator flap repair.Compare the efficacy,visual analogue scale (VAS) score,histopathological score,total finger mobility (TAM) score,sensory function grading,and comprehensive quality of life assessment questionnaire 74 (GQOLI-74) score between two groups before and after treatment.Result After 6 months of surgery,the therapeutic effect of the observation group was significantly higher than that of the control group (95.92% vs 79.59%)(P<0.05).On postoperative days 3 and 7,the VAS score of the observation group was significantly lower than that of the control group,while the histopathological score was significantly higher than that of the control group (P<0.05).After 6 months of surgery,the TAM score and sensory function grading in the observation group were (3.37±0.43) and (4.17±0.12) levels,respectively,higher than those in the control group (2.27±0.26) and (3.32±0.12) levels (P<0.05).After 6 months of surgery,the psychological,physical,social,and material function scores of the observation group were significantly higher than those of the control group (P<0.05).Conclusion The combination of microvascular technology and perforator flap repair has a significant therapeutic effect on patients with hand injury tissue injury,which can improve their hand sensation and motor function,alleviate pain,and improve tissue healing and quality of life.

Key words: via microvascular technique; perforating flap repair; soft tissue defects in hand trauma; hand function

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