应用三黄汤在腹部单蒂三叶皮瓣修复多指末端皮肤缺损围手术期的疗效观察

Curative effect observation of application of Sanhuang Decoction in perioperative repair of skin defect at the end of multi-finger with trifoliate flap with single pedicle of abdomen

目的:分析对于接受腹部单蒂三叶皮瓣修复治疗的多指末端皮肤缺损患者于围手术期内应用三黄汤的辅助治疗效果。方法:以我院2017年6月-2018年6月行腹部单蒂三叶皮瓣修复治疗的多指末端皮肤缺损患者90例为观察样本,以数字表法分组为观察组与对照组。对照组患者术后采取传统的碘伏消毒联合无菌纱布覆盖法,观察组患者则于术后采取三黄汤外敷治疗。比较对两组患者的临床疗效以及肿胀和疼痛的消退时间。结果:观察组患者的总体治疗有效率为97.78%,较同期对照组患者总体治疗有效率的84.44%更高,组间差异有统计学意义(χ^2=5.262,P=0.000);观察组患者经治疗疼痛消退时间为(2.02±0.21)d,较对照组的(4.16±1.21)d显著更短,且组间差异具有统计学意义(t=4.062,P=0.000);观察组患者的肿胀消退时间为(3.06±0.17)d,较对照组的肿胀消退时间(5.26±0.39)d显著更短,组间差异具有统计学意义(t=5.261,P=0.000)。结论:对于接受腹部单蒂三叶皮瓣修复治疗的多指末端皮肤缺损患者,通过应用中医药三黄汤的辅助治疗方案有助于促进患者局部疼痛和肿胀的消退,有利于提升临床疗效并缩短患者康复时间。

Objective: To analyze the effect of application of Sanhuang Decoction( 三黄汤) in peri-operative repair of skin defect at the end of multi-finger with trifoliate flap with single pedicle of abdomen. Methods: From June 2017 to June 2018, 90 cases of patients with skin defects at the end of multiple fingers treated with abdominal single-pedicle trilobular flap in our hospital were selected as the observation samples, and the observation group and the control group were divided according to the digital table method. The patients in the control group were covered with traditional iodide fumigation combined with sterile gauze after surgery, while the patients in the observation group were treated with external application of Sanhuang Decoction after surgery. The clinical efficacy and time of edema and pain were compared between the two groups. Results: The overall therapeutic response rate of the observation group was 97.78%, which was significantly higher than that of the control group(84.44%). The difference between the two groups was statistically significant(χ^2=5.262, P=0.000). The time of pain regression in the observation group was(2.02±0.21) d, which was significantly shorter than that in the control group(4.16±1.21) d, and the difference between the two groups was statistically significant(t=4.062, P=0.000). The edema regression time in the observation group was(3.06±0.17) d, which was significantly shorter than that in the control group(5.26±0.39) d, and the difference between the two groups was statistically significant(t=5.261, P=0.000). Conclusion: For patients with skin defects at the end of multiple fingers who have received the repair treatment of abdominal single-pedicle trilobular flap, the adjuvant treatment scheme of TCM Sanhuang Decoction is helpful to promote the regression of local pain and swelling, improve the clinical efficacy and shorten the recovery time of patients.