摘要
目的探讨重建感觉的逆行指动脉岛状皮瓣修复指端缺损的临床效果。方法选择29例指端缺损患者为研究对象,均行重建感觉的逆行指动脉岛状皮瓣修复治疗。观察患者指端愈合情况,比较患者术后不同时点皮瓣感觉指标、皮瓣感觉功能分级。结果29例患者中,共有2例患者治疗后发生静脉回流障碍问题,拆部分缝线后好转;其余患者皮瓣组织均愈合良好,所有患者切口均Ⅰ期愈合。术后1~3个月,近侧指间关节活动功能得到明显改善,术后6个月,掌指关节伸屈范围达到90°,近侧指关节活动范围在90~100°,远侧指关节活动范围在30~45°。术后1个月,29例患者深痛觉均完全恢复,浅感觉、两点辨别感觉均未恢复;术后3个月,23例患者浅感觉恢复;术后6个月,29例患者的浅感觉、深痛觉均完全恢复。术后不同时点浅感觉、两点辨别感觉比较差异有统计学意义(P<0.05)。术后1个月,患者皮瓣感觉功能分级均为S1级;术后3个月,患者皮瓣感觉功能分级S2级20例,S3级9例;术后6个月,患者皮瓣感觉功能分级S2级1例,S3级28例。患者术后不同时点皮瓣感觉功能分级比较差异有统计学意义(P<0.05)。结论重建感觉的逆行指动脉岛状皮瓣修复指端缺损效果良好,应用价值较高。
Objective To explore the clinical effect of reverse digital artery island flap with sense reconstruction for repairing finger tip defects.Methods 29 patients with finger tip defects were selected as study subjects,and all of them were treated with reverse digital artery island flap with sense reconstruction.The healing of the finger tips was observed,and the flap sensory indicators and flap sensory function grading at different time points after surgery were compared.Results Among the 29 patients,a total of 2 patients had impaired venous return after treatment,which was improved after partial suture removal;the flap tissues of the rest patients healed well,and the incisions of all the patients healed at stageⅠ.The function of proximal interphalangeal joint movement was significantly improved 1-3 months after surgery,and the range of extension and flexion of the metacarpophalangeal joint reached 90°6 months after surgery,the range of proximal interphalangeal joint movement was between 90-100°,and the range of distal interphalangeal joint movement was between 30-45°.1 month after surgery,deep nociception was fully recovered in 29 patients,and superficial sensation and two-point discrimination sensation were not recovered;3 months after surgery,superficial sensation was recovered in 23 patients;6 months after surgery,superficial sensation and deep nociception were fully recovered in 29 patients.The difference was statistically significant when comparing superficial sensation and two-point discrimination sensation at different time points after surgery(P<0.05).1 month after surgery,the patients'flap sensory function were all in grade S1;3 months after surgery,the patients'flap sensory function were grade S2 in 20 cases and grade S3 in 9 cases;6 months after surgery,the patients'flap sensory function were grade S2 in 1 case and grade S3 in 28 cases.The difference was statistically significant when comparing the flap sensory function grading at different time points(P<0.05).Conclusion The reverse digital artery is
作者
孔祥明
魏雪峰
李志
KONG Xiang-ming;WEI Xue-feng;LI Zhi(Department of Hand and Foot Microsurgery,Peixian People's Hospital,Xuzhou 221600,China)
出处
《中国实用医药》
2024年第15期64-67,共4页
China Practical Medicine
关键词
重建感觉
逆行指动脉岛状皮瓣修复
指端缺损
皮瓣感觉
Sense reconstruction
Reverse digital artery island flap
Finger tip defects
Flap sensation
