不同灌流方式下动脉化静脉皮瓣用于手部软组织缺损修复临床对比研究

目的: 探讨静脉逆瓣膜动脉化倒置吻合和静脉顺瓣膜动脉化不倒置吻合灌流方式用于手部软组织缺损修复临床效果差异。方法：研究对象选取我院2014年4月-2016年4月收治行动脉化静脉皮瓣修复手部软组织缺损患者80例，以随机数字表法分为A组（40例）和B组（40），分别采用静脉逆瓣膜动脉化倒置吻合和静脉顺瓣膜动脉化不倒置吻合灌流；比较两组患者手功能恢复优良率、皮瓣成活率、术后皮瓣反应分度及治疗满意度。结果：两组患者手功能恢复优良率比较差异无统计学意义（p>0.05）；B组患者术后皮瓣成活率显著高于A组（p<0.05）；B组患者术后皮瓣反应分度显著优于A组（p<0.05）；同时两组患者治疗满意度比较差异无统计学意义（p>0.05）。结论：静脉顺瓣膜动脉化不倒置吻合灌流用于手部软组织缺损修复可有效提高皮瓣存活率，改善术后皮瓣反应程度，价值优于静脉逆瓣膜动脉化倒置吻合。

Clinical comparative study of different perfusion modes of multiple leaf venous flaps on soft tissue defect repairment of hand

Objective To investigate clinical effects difference of anti-valve artefializod venous flap by inverted before anastomosi and pro-valve arterialized venous flap by no inverted before anastomosi on soft tissue defect repairment of hand. Methods 80 patients with soft tissue defect repairment of hand were chosen in the period from April 2014 to April 2016 in our hospital and randomly divided into two groups including A group (40 patients) with anti-valve artefializod venous flap by inverted before anastomosi and B group (40 patients) with pro-valve arterialized venous flap by no inverted before anastomosi; and the excellent and good rate of hand function recovery, flap survival rate, postoperative skin flap response degree and treatment satisfaction of both groups were compared. Results There was no significant difference in excellent and good rate of hand function recovery between 2 groups(p>0.05). The flap survival rate of B group were significant higher than A group(p<0.05). The postoperative skin flap response degree of B group were significant better than A group(p<0.05). There was no significant difference in the treatment satisfaction between 2 groups(p>0.05). Conclusion Compared with anti-valve artefializod venous flap by inverted before anastomosi, pro-valve arterialized venous flap by no inverted before anastomosi on soft tissue defect repairment of hand can efficiently higher the survival rate of flap and improve the flap response degree after operation.