摘要
目的比较腹部带蒂皮瓣和游离皮瓣修复手部感染创面及骨外露的临床效果。方法选取医院收治的38例手外伤后创面感染且骨外露患者为观察对象,按照入院顺序随机分为Ⅰ组和Ⅱ组,各10例,Ⅰ组患者行腹部带蒂皮瓣修复治疗,Ⅱ组患者行足背游离皮瓣修复治疗,比较两组患者的治疗效果。结果Ⅰ组患者治疗效果优良率为94.73%,Ⅱ组为63.16%,两组差异有统计学意义(P<0.05);Ⅰ组患者手术时间为(52.3±23.5)min,短于Ⅱ组(189.3±36.9)min;Ⅰ组患者住院时间为(39.5±3.2)d,长于Ⅱ组(19.4±1.2)d;Ⅰ组患者手术次数为(2.2±0.8)次,大于Ⅱ组(1.0±0.2)次;Ⅰ组患者总住院费用为(12 324.6±145.2)元,高于Ⅱ组(8734.2±45.6)元,两组差异均有统计学意义(P<0.05);Ⅰ组患者对治疗效果的满意率为52.63%,Ⅱ组为73.68%,两组差异无统计学意义。结论对于手外伤创面感染及骨外露的修复治疗,带蒂皮瓣术后成活率较高,有其不可替代的优点;而游离皮瓣修复可实现外形和功能的良好恢复,在技术允许的情况下可灵活选择。
OBJECTIVE To compare the clinical effects of the abdominal pedicle skin flap and free skin flap repair on the treatment of the hand infected wound and bone exposed. METHODS A total of 38 cases of patients with hand trauma wound infections and bone exposed were selected as the study objects and were randomly divided into the group Ⅰ and the group Ⅱ according to the admission order with 10 cases in each. The group Ⅰ was treated with the abdominal pedicle skin flap repair, and the group Ⅱ was given the acrotarsium free skin flap repair. The treatment effects of the two groups were compared. RESULTS The excellent and good rate of the treatment in the group Ⅰ was 94.73%, higher than 63.16% of the group Ⅱ , the difference was statistically significant （P〈 0.05）. The operation duration of the group Ⅰ was （52.3±23.5） min, shorter than （189.3±36.9）min of the group Ⅱ ; the hospital stay of the groupⅠ was （39. 5±3. 2） d, longer than （19.4±1. 2） d of the group Ⅱ ; the operation frequency of the group Ⅰ was （2.2±0.8） times, more than （1.0±0.2）times of the groupⅡ; the total hospitalization cost of the group Ⅰ was （12324. 6 ± 145. 2） yuan, higher than （8734. 2±45. 6） yuan of the group Ⅱ , the difference between the two groups was statistically significant（P〈 0.05）. The satisfaction rate for the treatment effect of the group Ⅰ was 52. 63%, the group Ⅱ 73. 68%, the difference was not statistically significant. CONCLUSION For the repair treatment of the hand trauma wound infection and bone exposed, the pedicle flap is with higher postoperative survival rate and has irreplaceable advantages, while the free skin flap can achieve good recovery of the shape and function, the two methods should be flexibly chosen under the technology available.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2013年第10期2357-2359,共3页
Chinese Journal of Nosocomiology
关键词
手外伤
创面修复
腹部带蒂皮瓣
游离皮瓣
Hand trauma
Wound repair
Abdominal pedicle flap
Free skin flap
