腕掌侧桡动脉掌浅支游离皮瓣对手指软组织缺损的治疗效果

Treatment effect of soft tissue defect of fingers with free flap of superficial palmar branch of wrist volar radial artery

目的探讨腕掌侧桡动脉掌浅支游离皮瓣对手指软组织缺损的治疗效果。方法选择2013年10月—2015年10月瑞安市人民医院(温州医科大学附属三院)手外科收治的80例手指软组织缺损患者,根据随机数字表,将患者随机分成2组。对照组患者(38例)给予指背筋膜皮瓣治疗,观察组(42例)给予腕掌侧桡动脉掌浅支游离皮瓣治疗方法。对患者随访1个月、6个月,观察手指外观、皮瓣成活率、手指功能。结果术后1个月,观察组手指外观与功能评分分别为(16.5±2.7)分和(15.8±3.4)分,高于对照组的(12.8±2.4)分和(13.6±3.2)分,P<0.05;术后6个月,手指外观与功能评分分别为(18.5±2.4)分和(18.7±3.3)分,高于对照组评分和1个月时评分,P<0.05;随访6个月时,观察组优良率为97.6%(41/42),高于对照组的优良率81.5%(31/38),P<0.05;观察组手指感觉、血液循环、恢复工作情况评分[(33.5±4.2)分、(26.4±4.3)分和(34.5±4.8)分]均高于对照组[(22.3±3.8)分、(16.9±4.5)分和(28.9±4.9)分],P<0.05。结论腕掌侧桡动脉掌浅支游离皮瓣更为适合手指软组织缺损的修复,改善软组织缺损手指外观,恢复手指功能,具有良好的应用前景。

Objective To investigate the therapeutic effect of soft tissue defect of fingers with free flap of superficial pal- mar branch of wrist volar radial artery. Methods Total 80 patients with finger soft tissue defects of Rui＇ an City People＇ s Hospital from October,2013 to October,2015 were randomly divided into two groups according to the number of hospital admissions and the random number table. Patients in control group（ n = 38 ） were given the dorsal fascia flap for treat- ment, and the patients in observation group（ n = 42 ） were given free flap of superficial palmar branch of wrist volar radial artery for treatment. The patients were followed up for 1 months and 6 months, to observe the appearance of the fingers, the survival rate of the skin flaps and the function of the fingers. Results One month after the surgery, the finger appearance and function scores of observation group were （ 16.5±2.7） and （ 15.8±3.4） points, higher than those of control group （ 12.8±2.4） and （ 13.6 ± 3.2） points, P 〈 0.05 ; 6 months after surgery, the finger appearance and function scores of observation group were 18.5 ±2.4 and 18.7±3.3, higher than those of control group and the scores of 1 month （P 〈 0.05 ） ; after 6 months of follow-up, the excellent rate of observation group was 97.6% （41/42）, higher than that of the control group 81.5 % （31/38 ） ,P 〈 0.05 ;the finger feeling, blood circulation and recovery score of observation group were （33.5±4.2）, （26.4±4.3） and （34.5±4.8） points,higher than those of the control group [（22.3±3.8）, （ 16.9±4.5 ） and （28.9±4.9） points ] ,P 〈 0.05. Conclusion The free flap of superficial palrnar branch of wrist volar radial artery is more suitable for the repair of the soft tissue defect of the finger. It can improve the appearance of the soft tissue defect and restore the function of the fingers with good application prospects.