逆行隐神经皮瓣交腿移位对治疗小腿远端、足踝部创面的效果分析

Application of reverse saphenous nerve flap in repairing distal lower leg, foot and ankle wounds with cross leg transfer

目的探讨逆行隐神经皮瓣交腿移位修复难治小腿远端、足踝部创面的临床效果。方法选择2015年1月至2018年1月唐山市第二医院手外科收治的难治小腿远端、足踝部创面患者100例,按照不同治疗方式分为观察组与对照组,各50例。观察组予以逆行隐神经皮瓣交腿移位修复,对照组予以传统方式修复(常规加压包扎及皮瓣移植治疗),比较2组患者优良率、愈合时间以及疼痛评分。结果观察组患者修复优良率74.00%明显高于对照组的58.00%,愈合时间(33.47±6.52)d明显短于对照组,2组比较差异有统计学意义(P<0.05)。观察组患者手术后6、12、24、48、72 h疼痛程度评分显著低于对照组(P<0.05);观察组患者术后15 d的血管分布评分(1.16±0.34)、柔软度评分(0.88±0.39)、色泽评分(1.51±0.75)、厚度评分(1.27±0.38)明显低于对照组,踝关节功能评分(82.52±4.39)明显高于对照组(P<0.05)。结论逆行隐神经皮瓣交腿移位修复难治小腿远端、足踝部创面的效果理想,可有效促进创面愈合,改善踝关节功能。

Objective To investigate the clinical effect of retrograde occult nerve flap in repairing distal calf and ankle wound by cross-leg displacement.Methods 100 cases of patients with distal calf and ankle wound treated by Tangshan Second Hospital from January 2015 to January 2018 were selected and divided into observation group and control group according to different treatment methods, 50 cases in each group.The observation group was treated with retrograde occult nerve flap, and the control group was repaired by traditional methods(conventional pressurized bandaging and flap transplantation), and the excellent healing rate, healing time and painscore of 2 groups were compared. Results The excellent healing rate in the observation group( 74%) was significantly higher than that in the control group( 58%),the healing time( 33. 47 ± 6. 52) d was significantly shorter than that in the control group,and there was statistically significant between the 2 groups( P < 0. 05).The pain level score of 6,12,24,48 and 72 h in the observation group was significantly lower than that in the control group( P < 0. 05). The vascular distribution score( 1. 16 ± 0. 34),softness score( 0. 88 ± 0. 39),color score( 1. 51 ± 0. 75),thickness score( 1. 27 ± 0. 38) were significantly lower in the observation 15 d group than that of the control group,and ankle function score( 82. 52 ± 4. 39) significantly higher than the control group( P < 0. 05). Conclusion The effect of retrograde occult nerve flap on the displacement of the distal calf and ankle wound is ideal,which can effectively promote wound healing and improve ankle joint function.