麻风假肢使用者残肢溃疡的手术效果

Stump Ulcer Repairing in People Affected by Leprosy

目的观察麻风假肢使用者残肢溃疡手术治疗的效果。方法采用残肢缩短和增生骨组织切除手术治疗残肢溃疡73例。结果术后残肢创面Ⅰ期愈合,随访3～12年,70例患者残肢未见新发和复发溃疡;3例残肢新发溃疡,经清创、休息、制动、维修假肢及更换内层垫,溃疡愈合未复发。结论外科手术切除残肢局部骨组织改变残端压力的分布,术后教患者掌握日常防护知识并坚持自我护理,可避免残肢溃疡的发生。

Objective To observe the effect of stump ulcer repairing in people affected by leprosy （PALs）. Methods Pone shortening and osteophyte removal were performed in 73 PALs amputees with stump ulcers. Results All the incisions were healed without any delay. During a follow-up period of 3-12 years, no relapse or new ulcers were found in 70 PALs. 3 PALs developed new ulcers, which were healed after debridement, resting, and prosthesis repairing. Conelusion Surgical revision of the bone in amputation stump can change the local distribution of pressure. Postoperative self-care teaching to the PALs and their sustaining daily self-care will finally prevent them from stump ulcer recurring.