对比掌腱膜部分切除术与掌腱膜切除加受累皮肤切除、皮肤移植术治疗掌腱膜挛缩症的临床效果

Clinical Effect Comparison of Palmar Aponeurosis Partial Resection, Palmar Aponeurosis Resection with Involved Skin Resection and Skin Transplantation in Treatment of Dupuytren's Contracture

目的对比掌腱膜部分切除术与掌腱膜切除加受累皮肤、皮肤移植术治疗掌腱膜挛缩症患者的临床疗效。方法筛选2008年1月至2013年1月我院收治的掌腱膜挛缩症患者56例,作为研究对象。采用随机数表法将其分为试验组与对照组,每组28例,对照组单纯应用掌腱膜部分切除术治疗,试验组采用掌腱膜切除联合受累皮肤切除、皮肤移植术用于治疗掌腱膜挛缩症,比较两组患者术后并发症并通过随访复查统计其临床疗效。结果随访复查显示对照组复发11例,试验组复发3例,两组术后复发率比较存在显著差异;试验组术后并发症皮下血肿1例,手指麻木1例,治疗总有效率92.86%,明显高于对照组(P<0.05)。结论采用掌腱膜切除联合受累皮肤切除、皮肤移植用于治疗掌腱膜挛缩症可显著提升其临床疗效,降低术后复发率及手术并发症,具有临床应用及推广价值。

Objective To compare the curative efifciency of palmar aponeurosis partial resection, palmar aponeurosis resection with involved skin resection and skin transplantation in treatment of Dupuytren＇s contracture. Methods Selected 56 Dupuytren＇s contracture patients who were treated from 2005 January to 2013 January in our hospital as the research object. They were randomly divided into the experimental group and control group, with 28 cases in each group, the control group was treated with palmar aponeurosis partial resection, the experiment group adopted the palmar aponeurosis resection with involved skin resection and skin transplantation to treat Dupuytren＇s contracture, counted curative effect through comparing complications and follow-up review after operation. Results The follow-up examination showed that there were 11 recurrence in the control group and 3 cases in experimental group, two groups’ postoperative recurrence rate were signiifcant difference;there was 1 case ecchymoma in the test group’ s postoperative complication, 1 case of numbness in the ifngers, the total effective rate was 92.86%, it was signiifcantly higher than the control group（P〈0.05）. Conclusion Palmar aponeurosis partial resection, palmar aponeurosis resection with involved skin resection and skin transplantation in the treatment of Dupuytren＇s contracture can signiifcantly improve the clinical curative effect, reduce the recurrence rate and complications after operation, it is worthy of application and promotion in clinic.