两种皮瓣转移成形术对骶尾部藏毛窦患者的治疗效果

Effects of Two Types of Flap Transposition Plasty on Patients with Sacrococcygeal Pilonidal Sinus

目的:评估两种皮瓣转移成形术对骶尾部藏毛窦患者的治疗效果。方法:选取2018年2月~2021年2月本院收治的80例骶尾部藏毛窦患者,简单随机分组为观察组(n=40)和对照组(n=40)。对照组行改良Dufourmentel皮瓣转移成形术,观察组行改良Limberg皮瓣转移成形术。记录手术时间、术中出血量、住院时间、术后并发症发生率、术后复发率、皮瓣坏死率、皮瓣下积液发生率及伤口一期愈合率,采用视觉模拟(VAS)评分评价疼痛程度。结果:观察组皮瓣坏死率、皮瓣下积液发生率、术后24 h、36 h的VAS评分均低于对照组,伤口一期愈合率高于对照组(均P<0.05);观察组手术时间、术中出血量以及住院时间均少于对照组(均P<0.05);观察组术后并发症发生率为10.00%,低于对照组30.00%(均P<0.05);观察组术后半年、1年的复发率分别为2.50%、5.00%,低于对照组20.00%、25.00%(均P<0.05)。结论:改良Limberg皮瓣转移成形术治疗骶尾部藏毛窦的疗效确切,可降低术后并发症发生率,减轻术后疼痛,且术后1年内复发率较低。

Objective:To evaluate effects of the two types of transposition plasty on patients with sacrococcygeal pilonidal sinus.Methods:A total of 80 patients with sacrococcygeal pilonidal sinus admitted to our hospital between February 2018 and February 2021 were enrolled.They were divided into the observation group and the control group by simple random grouping method,with 40 cases in each group.The control group underwent modified Dufourmentel flap transposition plasty,while the observation group underwent modified Limberg flap transposition plasty.The indicators including operation time,intraoperative blood loss,hospital stays,incidence of postoperative complications,recurrence rates,flap necrosis rate,incidence of liquid under flap,and primary wound healing rate were recorded.The pain degree was evaluated by visual analogue scale(VAS).Results:The flap necrosis rate,incidence of liquid under flap,and VAS scores at 24 h and 36 h after surgery were lower,while primary wound healing rate was higher in the observation group than those in the control group(all P<0.05).Compared to the control group,the operation time,intraoperative blood loss,and hospital stays in the observation group were all reduced(all P<0.05).The incidence of postoperative complications in the observation group was decreased when compared with the control group(10.00%vs 30.00%,P<0.05).The recurrence rates within 6 months and 1 year after surgery were both declined in the observation group than those in the control group(2.50%vs 20.00%;5.00%vs 25.00%;both P<0.05).Conclusion:The modified Limberg flap transposition plasty has good curative effect on sacrococcygeal pilonidal sinus,which can reduce the incidence of postoperative complications and alleviate postoperative pain,with lower recurrence rate within 1 year after surgery.