超回流技术在拇指皮神经营养血管皮瓣修复拇指末节缺损中的应用①
毛鹏 谢小军 吕白 黄家菊 王洪凯 韩健
桂林医学院第二附属医院
摘要：目的：探讨超回流技术在治疗拇指背尺侧逆行皮神经营养血管皮瓣修复拇指末节缺损中的价值。方法：选取拇指末节缺损患者32例，按照是否进行静脉吻合，将患者分为观察组18例和对照组14例。观察组使用超回流技术进行皮瓣内静脉吻合，对照组使用常规手术方式。比较两组术后的皮瓣存活、皮瓣肿胀、皮肤感觉、手指功能恢复、住院时间及住院费用。结果：所有皮瓣均存活；观察组术后皮瓣肿胀程度明显低于对照组（P＜0.05）;两组的皮肤感觉及手指功能恢复情况比较，差异无统计学意义（P＞0.05）;观察组住院时间、住院费用均少于对照组（P＜0.05）。结论：传统拇指背尺侧逆行皮神经营养血管皮瓣修复拇指末节缺损术式中，使用超回流技术可有助于患者康复，降低医疗费用。
关键词：超回流技术;皮神经营养血管皮瓣;拇指末节缺损;
Application of super-reflux technique in repairing the defect of thumb distal segment with cutaneous nerve nutrient vascular flap of thumb①
MAO Peng②,XIE Xiaojun,LV Bai,HUANG Jiaju,WANG Hongkai,HAN Jian③.(The 2nd Affiliated Hospital of Guilin Medical University,Guilin 541199,China)
Abstract Objective: To investigate the clinical effect of super-reflux technique on repairing the defect of the distal part of the thumb with retrograde cutaneous neurovascular flap on the dorsal ulnar side of the thumb. Methods: 32 patients with distal thumb defect were selected and randomized into two groups, with 18 cases in the observation group and 14 cases in the control group according to whether or not to conduct venous anastomosis. Venous anastomosis was performed by super-reflux technique to patients in the observation group, while the control group underwent conventional surgery. The flap survival, flap swelling, skin sensation, recovery of finger function, hospital stays and cost of hospitalization were compared between the two groups. Results: All flaps survived. The degree of postoperative swelling in the observation group was significantly lower than that in the control group(P<0.05); there were no significant differences in skin flap sensation and recovery of finger function between the two groups(P>0.05); the length of hospitalization and hospitalization cost in the observation group were less than those in the control group(P<0.05). Conclusion: Compared with the conventional repairing of the defect of the distal part of the thumb with retrograde cutaneous neurovascular flap on the ulnar side of the thumb, super-reflux technique can effectively quicken the patients’ recovery and reduce the expenses of hospitalization.
Keywords: super-reflux technique; cutaneous neurovascular flap; distal thumb defect
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