显微修复与普通修复在严重甲床损伤治疗中的比较

Comparison between microsurgical repair and regular repair in the treatment of severe nail bed injury

目的 比较显微修复及普通修复方法 治疗严重甲床损伤的疗效。方法 我院2010年6月至2014年3月收治严重甲床损伤120例148指,分别采用显微修复（60例82指）和普通修复（60例66指）治疗,术后对甲再生、并发症发生情况进行疗效分析。结果 术后随访2~12月,显微修复组52例66指I期愈合,8例16指出现并发症,其中1例1指甲床严重坏死;普通修复组32例33指I期愈合,28例33指出现并发症,其中8例10指甲床严重坏死。甲再生显微修复组优66指,良11指,可4指,差1指,优良率94%;普通修复组优24指,良14指,可18指,差10指,优良率57.6%。结论 治疗严重甲床组织损伤,显微修复具有较高的甲再生优良率和较低的并发症发生率,优于普通修复。

Objective To compare the clinical outcomes of severe nail bed injury treated with microsurgical repair and regular repair procedures. Methods Patients with severe nail bed injuries（120 cases, 148 fingers） in our hospital from June 2010 to March 2014 were divided into two groups.Patients in group A（60 cases, 82 fingers） and group B（60 cases, 66 fingers） were treated with microsurgical repair and regular repair,respectively. The postoperative clinical outcomes in terms of nail regeneration and complications were analyzed. Results The follow up period ranged from two to twelve months. In group A, 52 cases（66 fingers） healed primarily, while complications occurred in 8cases（16 fingers）, of which 1 case（1 finger） developed into nail bed necrosis. In group B, 32cases（33 fingers） healed primarily, while complications occurred in 28 cases（33 fingers）, of which8 cases（10 fingers） developed into nail bed necrosis. According to the evaluation criteria of nail bed regeneration, 66 fingers were graded as excellent, 11 fingers as good, 4 fingers as fair, 1 finger as bad in group A. Twenty-four fingers were graded as excellent, 14 fingers as good,18 fingers as fair,10 fingers as bad. Conclusion Microsurgical repair,with better nail regeneration and lower incidence of complications, is superior to regular repair for treating severe nail bed injury.