胫骨横向搬移治疗难愈性创面的临床研究进展

Progress of clinical study on the treatment of refractory wound by tibial transverse bone transfer

慢性难愈性创面有治疗周期长、治疗费用高、治疗效果不佳的特点,已逐渐成为当今医疗界亟须解决的难题。目前临床上常见的治疗措施包括彻底清创、局部抗感染、血管介入、持续负压吸引等方法,然而疗效均不尽如人意。胫骨横向搬移技术是基于Ilizarov技术进行的创新,因其在改善下肢血供、重建局部微循环等方面均能起到良好效果,国内越来越多的医师选择该方法治疗慢性难愈性创面。但胫骨横向搬移技术有再发骨折、溃疡复发等问题,且其在促进创面修复的生物学原理、手术方式、术后疗效评价等方面仍未取得共识。本文通过回顾国内外有关胫骨横向搬移治疗难愈性创面的研究,总结该技术的优势、不足及手术相关注意事项,为难愈性创面治疗提供新的思路。

Chronic refractory wounds are characterized by long treatment period,high treatment cost and poor treatment effect,which have gradually become an urgent problem in today’s medical field.At present,the common clinical treatment measures include thorough debridement,local anti-infection,vascular intervention,continuous negative pressure suction and other methods,but the curative effect is not satisfactory.Tibial transverse bone transfer technique is an innovation based on Ilizarov technique.Because it can improve the blood supply of lower limbs and reconstruct local microcirculation,more and more physicians in China choose this method to treat chronic refractory wounds.However,tibial transverse bone transfer technique has some problems such as recurrent fracture and ulcer recurrence,and there is still no consensus on its biological principle,surgical method and postoperative efficacy evaluation in promoting wound repair.In this paper,by reviewing the domestic and foreign studies on the treatment of refractory wounds by tibial transverse bone transfer,the advantages and disadvantages of this technique and the matters needing attention in surgery were summarized,so as to provide a new idea for the treatment of refractory wounds.