带蒂皮瓣覆盖软组织缺损康复效果的相关因素分析

Related factor analysis of rehabilitation effect of pedicle flap covering soft tissue defect

目的探究影响带蒂皮瓣覆盖软组织缺损康复效果的相关因素,旨在为临床的诊断和治疗提供参考。方法选取2014年1月至2017年1月接受治疗的83例带蒂皮瓣覆盖软组织缺损的患者为研究对象,将创口愈合的57例患者作为观察组,创口延迟愈合的26例患者作为对照组,比较两组患者的性别比例、吸烟史、病史及血清前白蛋白的变化情况,对两组患者比较具有统计学意义的数据进行Logistic多因素回归分析,研究影响带蒂皮瓣覆盖软组织缺损康复效果的危险因素。结果观察组男27例(47.37%),女30例(52.63%),对照组男14例(53.85%),女性12例(46.15%),差异无统计学意义(χ~2=0.300,P=0.584);有吸烟史患者观察组19例(33.33%),对照组20例(76.92%),差异具有统计学意义(χ~2=13.620,P=0.000);有糖尿病史患者观察组11例(19.30%),对照组19例(73.08%),差异有统计学意义(χ~2=22.374,P=0.000);有贫血史患者观察组21例(36.84%),对照组18例(69.23%),差异有统计学意义(χ~2=7.520,P=0.006);低蛋白血症观察组16例(28.07%),对照组20例(76.92%),差异有统计学意义(χ~2=17.350,P=0.000);血清前白蛋白降低观察组12例(21.05%),对照组21例(80.77%),差异有统计学意义(χ~2=26.585,P=0.000);对两组患者比较具有统计学意义的数据进行Logistic多因素回归分析,分析结果显示吸烟史、糖尿病史、贫血史、低蛋白血症以及低水平血清前白蛋白是影响带蒂皮瓣覆盖软组织缺损康复效果的危险因素(P<0.05,P<0.01)。结论吸烟史、糖尿病史、贫血史、低蛋白血症以及低水平血清前白蛋白是影响带蒂皮瓣覆盖软组织缺损康复效果的危险因素,临床上应该对以上指标加以控制,提高治疗效果。

Objective To explore the related factors of rehabilitation effect of pedicle flap covering soft tissue defect,and to provide the reference for clinical diagnosis and treatment. Methods A total of 83 patients with pedicle flaps covered soft tissue defect from January 2014 to January 2017 were selected as study objects. And 57 patients with wound healing were selected as observation group and 26 patients with delayed wound healing as control group. The gender ratio,smoking history,disease history and serum prealbumin before and after treatment were compared between the two groups. Logistic regression analysis was used to compare the factors with statistical significance between two groups,exploring the risk factors affecting rehabilitation effect of pedicle flap covering soft tissue defect. Results There were 27 males（ 47. 37%） and 30 females（ 52. 63%） in observation group,and were 14 males（ 53. 85%） and 12 females（ 46. 15%） in control group,the difference was not statistically significant（ χ^2= 0. 300,P = 0. 584）. There were 19 cases（ 33. 33%） in observation group and 20 cases（ 76. 92%） in control group with a history of smoking,the difference was statistically significant（ χ^2=13. 620,P = 0. 000）. There were 11 cases（ 19. 30%） in observation group and 19 cases（ 73. 08%） in control group with diabetes history,the difference was statistically significant（ χ^2= 22. 374,P = 0. 000）. There were 21 cases（ 36. 84%） in observation group and 18 cases（ 69. 23%） in control group with anemia,the difference was statistically significant（ χ^2=7. 520,P = 0. 006）. There were 16 cases（ 28. 07%） in observation group and 20 cases（ 76. 92%） in control group with hypoalbuminemia,the difference was statistically significant（ χ^2= 17. 350,P = 0. 000）. Serum prealbumin decreased in 12 cases（ 21. 05%） in observation group and 21 cases（ 80. 77%） in control group,the difference was statistically significant（ χ^2= 26. 585,P = 0. 000）. Multivariate logistic regression was used to compare the factors with statistical significance between two groups,and the result showed that smoking history,diabetes history,anemia,hypoalbuminemia and low prealbumin were risk factors influencing rehabilitation effect of pedicle flap to cover soft tissue defects（ P 〈0. 05,P 〈0. 01）. Conclusions The smoking history,diabetes history,anemia,hypoalbuminemia and low prealbumin are the risk factors that influence the effect of pedicle flap covering soft tissue defect. The above indexes should be controlled clinically to improve the therapeutic effect.