腓骨皮瓣交腿修复在血管损伤性胫骨感染及缺损中的应用

Effect of fibula flap cross-legged repair on treatment of patients with vascular injury tibial infection and defects

目的：研究合并血管损伤的胫骨感染及缺损的患者应用腓骨皮瓣交腿修复的临床效果，总结临床经验，探讨其在临床工作中的应用价值。方法收集医院2008年4月－2012年4月40例合并血管损伤的胫骨骨感染及缺损患者临床资料，对其进行回顾性分析，将40例患者随机分为治疗组、对照组，各20例，对照组患者行常规处理治疗，治疗组的患者行腓骨皮瓣交腿修复法，比较两组患者手术成功率，并发症概率与预后。结果移植皮瓣均成活，治疗组患者成功19例成功率达95．0％，对照组患者成功18例成功率为90．0％，两者差异无统计学意义；治疗组患者的治愈时间为5～10个月，平均（7．1±1．2）个月，对照组的患者治愈时间为6～24个月，平均（13．6±2．7）个月，差异有统计学意义（t＝9．84，P＜0．05）；治疗组发生并发症2例发生率为10．0％，远低于对照组患者的7例（35．0％），差异有统计学意义。结论腓骨皮瓣交腿修复具有操作简单、成功率高、并发症概率低、治愈周期短等特点，对合并血管损伤的胫骨骨感染及缺损患者的治疗效果确切，有效改善患者下肢功能，降低了患者的截肢率，提高其生活质量，值得在临床工作中推广、应用。

OBJECTIVE To study the clinical effect of fibula flap cross‐legged repair on treatment of the patients complicated with vascular injury tibial infection and defects ,summarize the clinical experience ,and explore the clinical value .METHODS The clinical data of 40 patients complicated with vascular injury tibial infection and de‐fects who were treated from Apr 2008 to Apr 2012 were retrospectively analyzed;the 40 patients were randomly divided into the treatment group and the control group ,with 20 cases in each .The control group was given the conventional therapy ,and the treatment group was treated with fibula flap cross‐legged repair ;the success rates of the surgeries ,incidence of complications ,and prognosis were observed and compared between the two groups of patients .RESULTS All the transplanted flaps survived .The success rate of the treatment group reached 95 .0%（19 cases） ,the success rate of the control group was 90 .0% （18 cases） ,and there was no significant difference between the two group .The healing time of the treatment group ranged from 5 to 10 months ,with the mean time of （7 .1 ± 1 .2）moths ;the healing time of the control group ranged from 6 to 24 months ,with the mean time of （13 .6 ± 2 .7）months ,and there was significant difference （t=9 .84 ,P〈0 .05） .The incidence of complications was 10 .0% （2 cases ） in the treatment group , significant lower than 35 .0% （7 cases ） in the control group . CONCLUSION The fibula flap cross‐legged repair is characterized by the simple operation ,high success rate ,low incidence of complications ,and short treatment cycle;it can achieve exact effect on treatment of the patients com‐plicated with vascular injury tibial infection and defects ,effectively improve the function of lower limbs ,and im‐prove the quality of life ,and it is worthy to be promoted in the hospital .