摘要
目的:探讨边缘切口与正中切口皮瓣修薄整形术的对比研究。方法:选取2018年1月-2019年12月于我院收治的皮瓣术后臃肿患者120例,根据手术治疗切口的不同,将行边缘切口皮瓣修薄整形术者纳入对照组(n=63),实施正中切口皮瓣修薄整形术者纳入观察组(n=57),比较2组患者的治疗效果及围术期相关指标,同时对患者相关血清炎性因子变化情况予以评估。结果:治疗后,2组患者的切口愈合情况无明显差异(P>0.05);观察组的修薄效果、血供情况相较于对照组更好,观察组的感觉恢复情况与对照组相比较差(P<0.05);与对照组相比较,观察组手术时间、术中出血量、神经损伤率均显著减少(P<0.05);治疗后,2组CRP、PCT和IL-6水平均较治疗前升高,且对照组炎症因子水平较观察组明显升高(P<0.05)。结论:边缘切口与正中切口皮瓣修薄整形术对皮肤创面的修复各有其优缺点,临床在行皮瓣修薄术时,应具体根据皮瓣形态、臃肿程度、修复部位等情况个性化地选择手术方式。相对于边缘切口皮瓣修薄术,2种术式均有较好的治疗效果,但正中切口皮瓣修薄整形术对皮瓣血运干扰更小,能有效提高机体愈合的生物学环境,减轻炎性反应,治疗效果更好,更有利于患者功能和外观的恢复,进一步提高患者生存质量,值得临床推荐应用。
Objective;To explore the comparative study of skin flap repair with marginal incision and median incision.Method;FromJanuary 2018 to December 2019,120 patients with postoperative bloated skin flaps were enrolled in our hospital.According to the differ-ent incisions of surgical treatment,the patients who underwent flap thinning with marginal incision were included in the control group(n=63).The patients in the observation group(n=57)were included in the operation group,and the therapeutic efect and perioperativeindexes of the two groups were compared,and the changes of sernum inflammatory factors were evaluated.Results:After treatment,therewas no significant difference in incision healing between the two groups(P>0.05);the thinning effect and blood supply of the observa-tion group were better than those of the control group,and the sensory recovery of the observation group was worse than that of the controlgroup(P<0.05);compared with the control group,the operation time,intraoperative hemorrhage and nerve injury rate of the observa-tion group were significantly reduced(P<0.05);after treatment,CRP,PCT and lL.-6 of the two groups were significantly reduced(P<0.05)The level of inflammatory factors in the control group was significantly higher than that in the observation group(P<0.05).Conclusion:There are advantages and disadvantages in the repair of skin wounds by the skin flap thinning with the marginal incision andthe median incision.When the skin flap is thinned,the operation mode should be selected according to the shape,the degree of bloatedskin flap and the repair site.Compared with the marginal incision flap thinning,the two methods have better therapeutic effect,but thenedian incision flap thimning surgery has less interference on the blood supply of the flap,can efectively heal the biological environmentof the body,reduce the inflammatory reaction,has better therapeutic effct,is more conducive to the recovery of the function and appear-ance of the patients,and further improves the quality of life of the patients,which is worth clinical recommendation.
作者
易远历
黄建华
孟宏
YI Yuan-li;HUANG Jian-hua;MENG Hong(Department of plastic surgery and microsurgery,central Peoples hospital of Huizhou,Huizhou,Zhejiang 516001)
出处
《中国伤残医学》
2021年第3期5-8,共4页
Chinese Journal of Trauma and Disability Medicine
