目的: 探讨桡神经浅支营养血管皮瓣修复手部皮肤缺损的临床疗效。方法: 选取2016年5月至2020年1月在深圳市龙岗区第六人民医院诊治的手部皮肤缺损患者114例,根据随机数字表法分为桡神经组和对照组,各57例。桡神经组给予桡神经浅支营养血管皮瓣修复治疗,对照组给予邻近皮瓣治疗,记录与随访两组患者的预后。结果: 所有患者都顺利完成手术,桡神经组的住院时间、上皮组织完全覆盖创面时间、换药次数、创面愈合时间少于对照组(P＜0.05)。术后3个月,桡神经组的皮瓣血供质地优良率为98.2 %,高于对照组的86.0 %(P＜0.05),桡神经组的静脉危象、瘢痕挛缩、创面坏死、创面感染等并发症发生率为3.5 %,低于对照组的17.5 %(P＜0.05);术后随访1年,桡神经组的手部感觉恢复功能情况好于对照组(P＜0.05),且满意率为100 %,高于对照组的89.5 %(P＜0.05)。结论: 相对于邻近皮瓣,桡神经浅支营养血管皮瓣应用于手部皮肤缺损修复可加快恢复患者的手部感觉功能,提高患者的皮瓣血供、质地优良率和满意度,减少并发症的发生。
Objective: To explore the clinical effect of the superficial branch of radial nerve nutrient vessel flap in repairing hand skin defect. Methods: From May 2016 to January 2020, 114 patients with hand skin defects weretreated in the Sixth People's Hospital of Longgang District were selected and divided into radial nerve group (n=57) and control group (n=57) according to random number table method. The radial nerve group was treated with superficial radial nerve nutrient vessel flap repair, and the control group was treated with adjacent flap. The prognosis of the two groups was recorded and followed up. Results: All patients were successfully completed the operation. The duration of hospitalization, the time of complete wound coverage, the number of dressing changes and the time of wound healing in the radial nerve group were less than those in the control group (P＜0.05). The excellent and good rate of flap blood supply texture in the radial nerve group 3 months after operation was 98.2 %, which was higher than 86.0 % in the control group (P＜0.05). The incidence of venous crisis, scar contracture, wound necrosis, wound infection and other complications in the radial nerve group at 3 months after operation was 3.5 %, which was lower than 17.5 % in the control group (P＜0.05). After one year of follow-up, the hand sensory recovery function in the radial nerve group was better than that in the control group (P＜0.05). The satisfaction rate of the radial nerve group was 100.0 %, which was higher than 89.5 % of the control group (P＜0.05). Conclusion: Compares with adjacent flaps, the application of superficial radial nerve nutrient vascular flaps can accelerate the recovery of hand sensory function in patients with hand skin defect, improve the blood supply, texture excellent rate and satisfaction of the flap, and reduce the incidence of complications.
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