摘要
目的:探讨显微外科在手术截肢创面修复中的应用效果。方法:选取2012年1月-2018年2月在笔者医院治疗的四肢严重创伤患者31例,均采用显微外科技术进行修复,手术方案按照股骨-血管-神经-肌肉-皮肤顺序再植肢体,采用90项临床症状自评量表(SCL-90)进行心理状况调查,采用Barthel指数评价日常生活能力。结果:31例患者经一期或二期组织瓣移植修复和植皮,创面愈合;28例患者可装配假肢以恢复部分肢体功能,可佩戴假肢率为90.32%。上肢和下肢一期创面愈合率72.73%和80.00%,差异无统计学意义(P>0.05)。男性患者SCL-90评分为(24.64±3.11)分,明显低于女性患者的(30.03±2.09)分,差异有统计学意义(P<0.05);不同性别Barthel指数评分比较,差异无统计学意义(P>0.05)。上肢和下肢受损患者SCL-90评分和Barthel指数比较,差异无统计学意义(P>0.05);不同年龄患者SCL-90评分和Barthel指数比较,差异无统计学意义(P>0.05)。结论:显微外科在手术截肢创面修复中有较好效果,有利于患者术后假肢佩戴,同时应注意对患者心理进行干预,特别是女性患者。
Objective To investigate clinical effect of microsurgery in the repair of amputated wounds.Methods From January 2012 to February 2018,31 patients with severe trauma of extremities in our hospital were selected,were repaired by microsurgical techniques,the operative plan was replanted according to the femoral-vascular-neuromuscular-skin-order,90 clinical symptom checklists(SCL-90)were used to investigate mental status and Barthel index was used to evaluate daily living ability.Results 31 patients were underwent primary or two stage tissue flap transplantation and skin grafting,and the wounds healed.28 patients could be fitted with prosthetic limbs to restore part of limb function,and the rate of wearing artificial limbs was 90.32%.The wound healing rate of upper limbs and the lower limbs was 72.73%and 80.00%,and the difference was not statistically significant(P>0.05).The score of 90 clinical symptoms self rating scale(SCL-90)of male patients was(24.64±3.11)scores,which was significantly lower than that of women(30.03±2.09)scores,the difference was statistically significant(P<0.05).There was no significant difference in Barthel index scores between different sexes(P>0.05).There was no significant difference in SCL-90 score and Barthel index between the upper limbs and the lower extremities(P>0.05).There was no significant difference in SCL-90 score and Barthel index between different age groups P>0.05).Conclusion Microsurgery has a good effect on the repair of the amputation wound,is beneficial to the patient to wear the prosthetic limb after operation,meanwhile,should pay attention to the psychological intervention of the patients,especially the female patients.
作者
崔太安
唐林俊
李献和
CUI Tai-an;TANG Lin-jun;LI Xian-he(Department of Hand Surgery,Modern Hospital of Sichuan,Chengdu 610045,Sichuan,China)
出处
《中国美容医学》
CAS
2018年第8期70-72,共3页
Chinese Journal of Aesthetic Medicine
关键词
显微外科
四肢创伤
截肢
临床效果
心理干预
microsurgery
limb trauma
amputation
clinical effect
psychological intervention
