摘要
目的探讨包埋皮瓣修复联合湿润烧伤膏(MEBO)治疗手指末节毁损性离断的临床疗效。方法将2012年6月至2013年6月肇庆市端州区红十字会医院收治的48例(64指)手指末节毁损性离断患者,按治疗方式的不同分为观察组(26例,34指)和对照组(22例,30指)。观察组采用包埋皮瓣修复联合MEBO治疗,对照组则采用包埋皮瓣修复断指。记录两组患者术后4周皮瓣优良率,比较术后6个月两组在断指存活、皮瓣存活、上皮化、指甲再生、骨折愈合、甲沟畸形、感染等指标的差异,根据关节总主动活动度(TAM)系统评定手指功能。结果比较两组术后4周皮瓣优良率,差异无统计学意义(P>0.05)。术后6个月两组断指存活率、皮瓣存活率均达100%,所有断指均获上皮化,骨折均获愈合;观察组TAM优良率、指甲再生良好率以及感染、甲沟畸形发生率等指标比较,观察组均优于对照组,差异有统计学意义(P<0.05)。结论包埋皮瓣修复联合MEBO治疗手指末节毁损性离断,手指关节活动度改善明显,感染、甲沟畸形等并发症发生率低,断指存活、皮瓣存活、上皮化、骨折愈合等方面的临床效果与传统方法相似,技术简单、安全,效果理想。
Objective To discuss clinical efficacy of buried flap repair combined with moist exposed burn ointment （MEBO） for destructive amputation of distal segment of finger. Methods According to different operations, 48 patients （64 fingers） treated from June 2012 to June 2013 in Red Cross Hospital of Duanzhou District of Zhaoqing City, were divided into observation group （26 patients 34 fingers, buried flap repair ＋MEBO） and control group （22 patients 30 fingers, buried flap repair only）. Excellent and good rate of flaps at 4 weeks after the surgery were recorded. At 6 months after the operation, differences of amputated finger survival, flap survival, epithelialization, nail regeneration, fracture healing, as well as complications such as infection, deformity of nail groove were compared between 2 groups;At the same time, activity of finger was evaluated by total active motion （TAM） system. Results At 4 weeks after the surgery, excellent and good rate of flap had no statistical difference between 2 groups （P 〉0.05）. At 6 months postoperatively, incidences of amputated finger survival and flap survival were all 100%, and all fingers in 2 groups got epithelialization and fracture healing;Differences of excellent and good rate of TAM, good rate of nail regeneration, incidences of infection as well as deformity of nail groove in observation group were all better than those in control group, there had statistical significance between 2 groups （P 〈0.05）. Conclusions Combination of buried flap repair and MEBO for destructive amputation of distal segment of finger is an simple and safe technique with satisfied clinical effects due to improvement of joint activity of finger, less complications of infection and deformity of nail groove, and similar effects to traditional operations at incidences of amputated finger survival, flap survival, epithelialization and bone fractures.
出处
《中国骨科临床与基础研究杂志》
2014年第3期154-158,共5页
Chinese Orthopaedic Journal of Clinical and Basic Research
基金
2012年肇庆市科技创新计划项目(2012E326)
关键词
指损伤
再植术
外科皮瓣
湿润烧伤膏
术后并发症
功能恢复
Finger injuries
Replantation
Surgical flaps
Moist exposed burn ointment
Postoperative complications
Recovery of function
