中华烧伤杂志
中華燒傷雜誌
중화소상잡지
16
2010年
1期
30-33
,共4页
谢卫国%王德运%刘杰峰%龙忠恒%李进%蒋梅君
謝衛國%王德運%劉傑峰%龍忠恆%李進%蔣梅君
사위국%왕덕운%류걸봉%룡충항%리진%장매군
烧伤,电%手%外科皮瓣%创面修复
燒傷,電%手%外科皮瓣%創麵脩複
소상,전%수%외과피판%창면수복
Burns,electric%Hand%Surgical flaps%Wound repair
目的 总结用皮瓣修复手部电烧伤创面的经验与不足,以期不断完善. 方法 收集整理2000年1月-2006年12月武汉市第三医院暨武汉大学同仁医院烧伤研究所收治的425例手部电烧伤患者资料,统计分析其治疗概况及结果,归纳总结行皮瓣移植术患者的皮瓣类型、术后并发症及存在的问题.根据皮瓣修复手术时机,将患者分为受伤7 d内手术组和受伤7 d后手术组,比较2组患者皮瓣成活率及并发症发生率. 结果 425例患者中,348例行手术治疗占90.2%,其中209例行不同类型皮瓣移植共248例次,包括远位带蒂皮瓣202例次占81.5%、局部皮瓣19例次占7.7%、游离皮瓣12例次占4.8%、其他类型组织瓣15例次占6.0%.5例因皮瓣撕脱或坏死改用其他方法治疗.8例皮瓣远端少许坏死,经换药或补植小皮片后愈合.其余皮瓣均完全成活,创面一次修复,功能及外观较满意.受伤7 d内手术组(170例次)和受伤7 d后手术组(78例次)患者,皮瓣成活率分别为98.8%(168/170)及96.2%(75/78),并发症发生率分别为10.6%(18/170)及12.8%(10/78),两指标组间比较,差异均无统计学意义(X~2值分别为0.81、0.27,P值均大于0.05). 结论 可用于修复手部电烧伤创面的皮瓣类型较多.合理选择和设计皮瓣、提高操作的熟练程度及术后正确观察与处理,是取得良好疗效的重要环节.
目的 總結用皮瓣脩複手部電燒傷創麵的經驗與不足,以期不斷完善. 方法 收集整理2000年1月-2006年12月武漢市第三醫院暨武漢大學同仁醫院燒傷研究所收治的425例手部電燒傷患者資料,統計分析其治療概況及結果,歸納總結行皮瓣移植術患者的皮瓣類型、術後併髮癥及存在的問題.根據皮瓣脩複手術時機,將患者分為受傷7 d內手術組和受傷7 d後手術組,比較2組患者皮瓣成活率及併髮癥髮生率. 結果 425例患者中,348例行手術治療佔90.2%,其中209例行不同類型皮瓣移植共248例次,包括遠位帶蒂皮瓣202例次佔81.5%、跼部皮瓣19例次佔7.7%、遊離皮瓣12例次佔4.8%、其他類型組織瓣15例次佔6.0%.5例因皮瓣撕脫或壞死改用其他方法治療.8例皮瓣遠耑少許壞死,經換藥或補植小皮片後愈閤.其餘皮瓣均完全成活,創麵一次脩複,功能及外觀較滿意.受傷7 d內手術組(170例次)和受傷7 d後手術組(78例次)患者,皮瓣成活率分彆為98.8%(168/170)及96.2%(75/78),併髮癥髮生率分彆為10.6%(18/170)及12.8%(10/78),兩指標組間比較,差異均無統計學意義(X~2值分彆為0.81、0.27,P值均大于0.05). 結論 可用于脩複手部電燒傷創麵的皮瓣類型較多.閤理選擇和設計皮瓣、提高操作的熟練程度及術後正確觀察與處理,是取得良好療效的重要環節.
목적 총결용피판수복수부전소상창면적경험여불족,이기불단완선. 방법 수집정리2000년1월-2006년12월무한시제삼의원기무한대학동인의원소상연구소수치적425례수부전소상환자자료,통계분석기치료개황급결과,귀납총결행피판이식술환자적피판류형、술후병발증급존재적문제.근거피판수복수술시궤,장환자분위수상7 d내수술조화수상7 d후수술조,비교2조환자피판성활솔급병발증발생솔. 결과 425례환자중,348례행수술치료점90.2%,기중209례행불동류형피판이식공248례차,포괄원위대체피판202례차점81.5%、국부피판19례차점7.7%、유리피판12례차점4.8%、기타류형조직판15례차점6.0%.5례인피판시탈혹배사개용기타방법치료.8례피판원단소허배사,경환약혹보식소피편후유합.기여피판균완전성활,창면일차수복,공능급외관교만의.수상7 d내수술조(170례차)화수상7 d후수술조(78례차)환자,피판성활솔분별위98.8%(168/170)급96.2%(75/78),병발증발생솔분별위10.6%(18/170)급12.8%(10/78),량지표조간비교,차이균무통계학의의(X~2치분별위0.81、0.27,P치균대우0.05). 결론 가용우수복수부전소상창면적피판류형교다.합리선택화설계피판、제고조작적숙련정도급술후정학관찰여처리,시취득량호료효적중요배절.
Objective To summarize the experiences and shortcomings of repair of wounds on hands due to electrical burns with flaps, aiming at further improvement. Methods Clinical data of 425 patients with electrical burn of hands admitted to Burn Institute of Wuhan City Hospital NO.3 & Tongren Hospital of Wuhan University from January 2000 to December 2006 were collected and summarized. Thera-peutic methods and outcomes of all patients were statistically analyzed. Flap types, complications after sur-gery and problems existed in patients having undergone flap transplantation were summarized. Patients were divided into surgery within 7 days post burn (PBD) group (SW) and surgery after PBD 7 group (SA) ac-cording to the timing of surgery. Survival rate of flaps and incidence of complications in patients of two groups were compared. Results Out of the 425 patients, 348 (90.2%) patients underwent surgery, a-mong which 248 flaps of different types were transplanted in 209 patients, including 202 (81.5%) distant pedicled flaps, 19 (7.7%) local flaps, 12(4.8%) free flaps, and 15 (6.0%) other kinds of tissue flaps. Five flaps failed because of necrosis or torn off, and the resulting wounds were treated with other meth-ods. Eight flaps showed necrosis of distal margin, and the wounds healed with dressing changing or skin grafting. All the remaining flaps survived with satisfactory cosmetic and functional results. In SW group (n=170) and SA group (n=78), survival rate of flaps was respectively 98.8% (168/170) and 96.2% (75/78), incidence of complications was respectively 10.6% (18/170) and 12.8% (10/78). There was no statistical difference between above two sets of data (with X~2 value respectively 0.81 and 0.27, and P values both above 0.05). Conclusions There are many types of flaps that can be used to repair electric burn wounds on hands. Appropriate choice and design of flaps, skillful operation, and careful post-operation observation and treatment are key points for good therapeutic effect.
