手外伤带蒂皮瓣修复不同时间断蒂的临床研究

目的探讨手外伤带蒂皮瓣修复不同时间断蒂的临床效果。方法将300例手外伤行带蒂皮瓣修复的患者随机分为观察组和对照组各150例,观察组术后14天断蒂,对照组21天断蒂。于术后第1、7、14天及断蒂后观察记录皮瓣颜色、温度、皮瓣毛细血管反应和针刺出血率,断蒂前观察断流试验,以及皮瓣存活率、住院时间和住院费用,术后随访1年。结果两组患者皮瓣颜色、温度、皮瓣毛细血管反应、针刺出血率和断流试验比较,差异均无统计学意义(P>0.05);两组患者断蒂后皮瓣全部成活,无感染病例发生;观察组患者住院时间和医疗费用明显少于对照组,P<0.05。术后随访1年,两组患者手外形及功能恢复良好。结论手外伤带蒂皮瓣修复术后14天断蒂是可行的,并可减少住院时间,节省住院费用,值得临床推广应用。

Clinical study on the different pedicle division time in treatment of hand injuries with pedicle flap

Objective To investigate the clinical efficacy of different pedicle division time in treatment of hand injuries with pedicle flap. Methods 300 cases of hand trauma patients treated with pedicle flap were randomly divided into two groups,the control group(150 cases,the pedicle division time is 14 days) and the observation group(150 case,the pedicle division time is 21 days).The flap color,temperature,flap capillary reaction,acupuncture bleeding rate were observed on 1,7,14 days after surgery and the day of pedicle division.The test of blocking blood supply before pedicle division,survival rate of skin flap,length of hospital stay and hospital costs were all observed.Results There were no significant differences on flap color,temperature,flap capillary reaction,acupuncture bleeding rate and the test of blocking blood supply before pedicle division in both two groups(P>0.05).All flaps in patients survived,and there is no infection occurred.The hospital stay and cost in observation group was significantly less than those in control group(P<0.05).After one-year follow up,patients of both two groups have good hand shape and functional recovery.Conclusion The 14-day pedicle divison time is feasible in treatment of hand injuries with pedicle flap.It reduces hospital stay and cost and is worthy of clinical application.