股前外侧穿支皮瓣修复术与胸腹带蒂皮瓣修复术治疗手外伤组织缺损的效果及对Jamar握力与DASH评分的影响

Effect of anterolateral thigh perforator flap repair and thoracoabdominal pedicle flap repair on tissue defect of hand trauma and its influences on Jamar grip strength and DASH score

目的 探讨股前外侧穿支皮瓣修复术与胸腹带蒂皮瓣修复术治疗手外伤组织缺损的效果及对Jamar握力与上肢功能评定表(DASH)评分的影响。方法 选取2019年1月至2021年1月本院收治的60例手外伤组织缺损患者,按修复方法不同将其分为A组和B组,各30例。A组给予胸腹带蒂皮瓣修复术治疗,B组给予股前外侧穿支皮瓣修复术治疗。比较两组的治疗效果。结果 B组的皮瓣修复优良率为96.67%,高于A组的73.33%,差异具有统计学意义(P<0.05)。B组的患肢功能恢复优良率为93.33%,高于A组的70.00%,差异具有统计学意义(P<0.05)。术后3 d,两组的血流灌注量相对值、血流速度均升高,且B组高于A组,差异具有统计学意义(P<0.05)。术后30 d,两组的Jamar握力均升高,DASH评分均降低,且B组优于A组,差异具有统计学意义(P<0.05)。结论 与胸腹带蒂皮瓣修复术比较,手外伤组织缺损患者应用股前外侧穿支皮瓣修复术有助于提升皮瓣修复效果及患肢功能恢复效果,改善缺损点血运,提升Jamar握力,有效恢复手部功能。

Objective To explore the effect of anterolateral thigh perforator flap repair and thoracoabdominal pedicle flap repair on tissue defect of hand trauma and its influences on Jamar grip strength and Disability of Arm-Shoulder-Hand(DASH)score.Methods From January 2019 to January 2021,60 patients with tissue defect of hand trauma admitted in our hospital were selected and divided into group A and group B according to different repair methods,with 30 cases in each group.The group A was treated with thoracoabdominal pedicle flap repair,and the group B was treated with anterolateral thigh perforator flap repair.The therapeutic effects of the two groups were compared.Results The excellent and good rate of flap repair in the group B was 96.67%,which was higher than 73.33%in the group A,and the difference was statistically significant(P<0.05).The excellent and good rate of limb function recovery in the group B was 93.33%,which was higher than 70.00%in the group A,and the difference was statistically significant(P<0.05).At 3 d after operation,the relative value of blood perfusion and blood flow velocity in the two groups increased,those in the group B were higher than the group A,and the differences were statistically significant(P<0.05).At 30 d after operation,the Jamar grip strength of the two groups increased,the DASH score decreased,those in the group B were better than the group A,and the differences were statistically significant(P<0.05).Conclusion Compared with thoracoabdominal pedicle flap repair,the anterolateral thigh perforator flap repair in patients with tissue defect of hand trauma is helpful to improve the effect of flap repair and limb function recovery,improve the blood supply of defect point,improve Jamar grip strength and effectively restore hand function.