甲床甲母质部分切除术对嵌甲甲沟炎的疗效及术后甲沟感染再发的影响

INFLUENCES OF PARTIAL LARYNGECTOMY OF NAIL BED AND NAIL MATRIX ON THE THERAPEUTIC EFFECTS AND THE RECURRENCE OF POSTOPERATIVE INFECTIONS IN NAIL GROOVE OF THE PATIENTS WITH INGROWN TOENAILS PARONYCHIA

目的分析甲床甲母质部分切除术对嵌甲甲沟炎（ITP）的疗效及术后甲沟感染再发的影响，为合理制定临床治疗控制方案提供客观依据。方法选择2010年12月-2013年12月180例ITP患者作为研究对象，将其随机分为A组、B组和C组，每组各60例，A组患者行全甲拔除术，B组患者行部分甲拔除术，C组患者行甲床甲母质部分切除术，对三组患者愈合时间、换药次数、治愈率及术后甲沟感染再发率及畸形、疼痛、复发的发生率进行观察和比较。结果A、B、C三组患者的愈合时间依次缩短、换药次数依次减少，而且C组患者的治愈率显著高于A组或B组，差异均有统计学意义（P〈0O．05）；C组患者的术后甲沟感染再发率低于A组或B组，差异有统计学意义（χ2=22．477、17．965，P〈0．05），疼痛、畸形、复发的发生率低于A组或B组。差异有统计学意义（χ2=31．509、26．864、11．346、9．326、44．169、42681，P〈0．05）。结论应用甲床甲母质部分切除术治疗ITP，能够加速创面愈合、提高治愈率，并可预防术后畸形的出现和疾病的复发，在降低术后甲沟感染再发率方面具有显著的效果。

Objective To analyze the influences of partial laryngectomy of nail bed and nail matrix on the therapeutic effects and the recurrence of postoperative infections in nail groove of the patients with ingrown toenails paronychia （ITP）, and to provide an objective basis for the formulation of rational clinical treatment control scheme. Methods A total of 180 cases of patients with ITP from December 2010 toDecember 2013 were selected as the research subjects and randomly divided into group A, group B and group C. 60 cases were included into each group. The patients in group A were treated with extraction of whole nail, the patients in group B were treated with extraction of partial nail, the patients in group C were treated with partial laryngectomy of nail bed and nail matrix. The healing time, the dressing change frequency, the curing rate as wall the recurrence of postoperative infections in nail groove and the incidences of deformity, pain, recurrence of the patients in the three groups were observed and compared. Results The healing time of the patients in the three groups of group A, B, C were shortened gradually and the dressing change frequency of the patients in the three groups of group A, 13, C were reduced gradually. The curing rate of the patients in group C was significantly higher than that in group A or group B. The differences were statistically significant （P〈0.05） ; the recurrence of postoperative infections in nail groove of the patients in group C was lower than that in group A or group B and the differences were statistically significant （χ2 = 22. 477, 17. 965,P〈0.05）. The incidences of pain, deformity and recurrence were lower than those in group A or group B, the differences were statistically significant （χ2 = 31. 509, 26. 864, 11. 346, 9. 326, 44. 169, 42681, allP（0.05）. Conclusions The application of partial laryngectomy of nail bed and nail matrix in treatment of ITP can accelerate the wound healing, improve the curing rate, prevent the incidence of postoperative deformity and the recurrence of diseases, and put significant effects in reducing the recurrence of postoperative infections in nail groove of the patients. observation .