不同逆行岛状皮瓣修复方案在拇指创伤中的疗效比较

目的] 探讨大鱼际逆行岛状皮瓣和拇指逆行桡背侧皮瓣修复拇指创面患者的临床疗效.方法] 选取2013年2月至2016年6月在本院接受治疗的拇指损伤患者88例,按照患者拇指手术修复部位分成大鱼际组、拇指桡背组.比较两组患者手术时间、术中出血量、术后视觉痛觉评分(VAS)、主观满意度、患者术后恢复时间、术后关节活动度、感觉、复工时间及拇指血液流量.结果] 大鱼际组手术时间、术中出血量、术后VAS评分均明显少于拇指桡背组,其差异有统计学意义(P<0.05);大鱼际组指背部位满意度评分明显高于拇指桡背组,而拇指桡背组指腹、指尖部位满意度评分明显高于大鱼际组,其差异均有统计学意义(P<0.05);拇指桡背组术后活动度、感觉测量分数均明显高于大鱼际组,而大鱼际组术后恢复时间、复工时间短于拇指桡背组,术后血液流量大于拇指桡背组,其差异均有统计学意义(P<0.05).结论] 拇指逆行桡背侧皮瓣修复术适合修复带有感觉功能的指腹部分;而大鱼际逆行岛状皮瓣修复术适合修复不带有感觉功能的指背部分.

Comparative Analysis of the Effect of Different Retrograde Island Flap in the Repair of Thumb Trauma

Objective]To explore the clinical effect of thenar retrograde island flap and radial dorsal thumb retrograde flap to repair thumb wound patients and to provide reference for clinical promotion.Methods]A total of 88 thumb injury patients from February 2013 to June 2016 in our hospital were selected as the research object.According to surgical repair of injured thumb position, patients were divided into 2 groups: the thenar group and the thumb radial dorsal group.Operation time, intraoperative blood loss, postoperative visual pain score (VAS), postoperative recovery of joint activity and sensory, measurement of blood flow to the thumb and patients' satisfaction evaluation were recorded and evaluated in the two groups.Results]The operative time, intraoperative blood loss and postoperative VAS score of the thenar group were significantly lower than those of the thumb radial dorsal group (P<0.05).Patients in the thenar group showed more satisfaction with dorsal part, and patients in the thumb radial dorsal group were more satisfied with ventral thumb and fingertip.The postoperative joint activity and sensory measurement scores of the thumb radial dorsal group were significantly higher than those of the thenar group.The recovery time after surgery was shorter and the blood flow to thumb in the thenar group was greater than those of the thumb radial dorsal group.All the differences were statistically significant (P<0.05).Conclusion]The radial dorsal thumb retrograde flap repair is suitable for repairing the sensory function of the ventral part of thumb, and thenar retrograde island flap is suitable for repairing the dorsal part of thumb, which has less sensory function.