摘要
目的探讨快速康复外科(fast track surgery,FTS)在行扩张穿支皮瓣游离移植术的面颈部大面积瘢痕患者中的应用效果。方法选取2016年6月至2018年12月于重庆医科大学附属第一医院行扩张穿支皮瓣游离移植术的62例面颈部大面积瘢痕患者为研究对象,采用随机数表法将其分为观察组和对照组,每组各31例。对照组患者采用常规围术期干预,观察组患者采用FTS综合干预,比较两组患者围术期康复相关指标、肩关节功能和临床满意度。结果所有患者的扩张穿支皮瓣均移植成功,且未发生血管危象等严重并发症。观察组患者术后住院天数显著短于对照组(P<0.05)。两组患者皮瓣移植成功率、供瓣区旁的扩张率、并发症发生率、挛缩复发率比较差异均无统计学意义(均P>0.05)。两组患者治疗后肩关节功能评分均显著高于本组治疗前(均P<0.05),且观察组患者治疗后肩关节功能评分显著高于对照组(P<0.05)。观察组患者出院时临床总满意率显著高于对照组(P<0.05)。结论围术期实施FTS干预在行扩张穿支皮瓣游离移植的面颈部大面积瘢痕患者中的应用效果令人满意,能显著促进患者术后康复,提高临床满意度,值得推广应用。
Objective To investigate the effect of fast track surgery(FTS)on patients with large area scar of face and neck undergoing free transplantation of expanded perforator flaps.Method Sixty-two patients with large area scar of face and neck who underwent free transplantation of expanded perforator flaps from June 2016 to December 2018 in the First Affiliated Hospital of Chongqing Medical University were enrolled for the study and randomly divided into observation group(n=31)and control group(n=31).Patients in control group were given routine perioperative intervention and patients in observation group were given FTS comprehensive intervention during perioperative period.The rehabilitation related indexes,shoulder joint function and clinical satisfaction of patients were compared between the two groups.Result All the flaps were successfully transplanted without serious complications including vascular crisis.The postoperative hospital stay in observation group was significantly shorter than that in control group(P<0.05).There were no significant differences in the success rate of flap transplantation,the expansion rate beside the donor valve area,incidence of complications and the recurrence rate of contracture between the two groups(all P>0.05).The shoulder function score after treatment in the two groups were significantly higher than those before treatment(all P<0.05),and the shoulder function score after treatment in observation group were significantly higher than that in control group(P<0.05).The total satisfaction rate of observation group was significantly higher than that of control group(P<0.05).Conclusion The application of FTS intervention is satisfactory in the patients with large area scar of face and neck undergoing free transplantation of expanded perforator flaps.It can significantly promote the postoperative rehabilitation and improve the clinical satisfaction,which is worth popularizing.
作者
杜雪梅
白伟志
DU Xue-mei;BAI Wei-zhi(Department of Burn,the First Affiliated Hospital of Chongqing Medical University,Chongqing 400018,China;Division of Emergency Medicine,Emergency Medical Center of Chongqing City,Chongqing 400014,China)
出处
《中国医学前沿杂志（电子版）》
2019年第12期131-135,共5页
Chinese Journal of the Frontiers of Medical Science(Electronic Version)
关键词
快速康复外科
瘢痕
穿支皮瓣
扩张术
术后康复
Fast track surgery
Scar
Perforator flap
Expansion
Postoperative rehabilitation
