游离股前外侧筋膜瓣和皮瓣治疗手足软组织创伤疗效对比

Curative Effect of Free Anterolateral Femoral Fascia Flap and Flap Surgery in the Treatment of Hand and Foot Soft Tissue Wound

目的研究分析手足软组织创伤患者接受游离股前外侧筋膜瓣和皮瓣修复手术的临床治疗效果。方法根据2006年6月~2011年12月我院的62例手足软组织缺损患者进行研究分析,对照组有30例,使用股前外侧皮瓣游离移植术,观察组有32例,使用游离股前外侧筋膜瓣改良植皮修复术,对比分析两组的愈合情况和并发症情况,随访6~18个月。结果观察组患者的筋膜瓣成活情况良好,外观和质地均非常理想,感觉正常;对照组有8例出现静脉危象,为患者拆线和使用罂粟碱后,症状缓解,创面II期愈合良好。创面I期,观察组优于对照组（100%vs.73.3%,χ2=9.798,P=0.002）,差异有统计学意义（P〈0.05）。结论手足软组织创伤可以选择游离股前外侧筋膜瓣治疗,患者的I、II期创面愈合良好,效果比股前外侧皮瓣修复术优秀。

Objective To study the foot soft tissue trauma patients with clinical therapeutic effect of free anterolateral femoral fascia flap and flap surgery. Methods According to 62 cases of hand and foot soft tissue defect were to conduct research and analysis in our hospital from June 2006 to December 2011. Control group of 30 cases,using the anterolateral thigh free flap transplantation,observation group 32 cases,using free anterolateral lateral fascia flap modified graft repair,the contrastive analysis of two groups of healing and complications up 6 to 18 month. Results Observation group patients with fascia flap survival in good condition,appearance and texture were very ideal,normal sensation. Venous crisis occurred in 8 cases in the control group,patients took out stitches and use papaverine,relieve symptoms,II in wound healed well. Phase I of the wound,the observation group than the control group（100% vs. 73.3%, χ2=9.798,P=0.002）,there was a significant difference（P〈0.05）. Conclusion Foot soft tissue trauma can choose free anterolateral femoral flap for the treatment,patients with stage II,I,wound healing is good,and is better than the anterolateral thigh flap repair.