CAJ | 학술논문

目的：比较局部换药及局部换药＋患侧星状神经节阻滞（ SGB）两种方法在手外伤性皮肤软组织缺损修复中的临床疗效，评价 SGB 的作用。方法手外伤性皮肤软组织缺损患者共84例，皮肤缺损面积最小0.5 cm ×1.0 cm，最大11 cm ×10 cm，平均22.5 cm2；治疗时间5~32 d。随机分成两组，每组42例，治疗组（ A组）采用局部换药＋星状神经节阻滞，对照组（ B组）仅采用局部换药，比较两组创面皮肤表皮生长覆盖速度，局部血流变化、皮温变化。结果治疗组在SGB后0.5 h，血流速度及皮温明显高于对照组；治疗组平均生长速度快于对照组。结论 SGB可有效促进皮肤软组织愈合，治疗中不影响正常的手功能康复训练，可有效预防关节僵硬、肌腱粘连、皮肤挛缩，最大限度地降低医源性手功能障碍风险，在手外伤皮肤软组织缺损的治疗中与其他方法相比具有独特优势。
목적：비교국부환약급국부환약＋환측성상신경절조체（ SGB）량충방법재수외상성피부연조직결손수복중적림상료효，평개 SGB 적작용。방법수외상성피부연조직결손환자공84례，피부결손면적최소0.5 cm ×1.0 cm，최대11 cm ×10 cm，평균22.5 cm2；치료시간5~32 d。수궤분성량조，매조42례，치료조（ A조）채용국부환약＋성상신경절조체，대조조（ B조）부채용국부환약，비교량조창면피부표피생장복개속도，국부혈류변화、피온변화。결과치료조재SGB후0.5 h，혈류속도급피온명현고우대조조；치료조평균생장속도쾌우대조조。결론 SGB가유효촉진피부연조직유합，치료중불영향정상적수공능강복훈련，가유효예방관절강경、기건점련、피부련축，최대한도지강저의원성수공능장애풍험，재수외상피부연조직결손적치료중여기타방법상비구유독특우세。
Objective To evaluate the effect of local dressing + ipsilateral stellate ganglion block(SGB)on traumatic hand skin and soft tissue defects by the comparison with that of local dressing. Methods 84 cases with traumatic hand skin and soft tissue defects were observed,the wound areas were from 0. 5 cm × 1. 0 cm,the smallest,to 11 cm × 10 cm,the biggest,the average was 22. 5 cm2;the course lasted from 5 to 32 days;the cases were randomly divided into 2 groups:group A and group B,42 cases in each. Local dressing was performed in both groups,while SGB was added to cases in group A;the wound epidermal growth,changes of local blood flow and skin temperature of the cases were compared between the 2 groups. Results The blood flow speed and skin temperature of the cases in group A half an hour after administration of SGB were much higher than those of the cases in group B;the average speed of epidermal growth in group A was faster than that in group B. Conclusions SGB can effectively promote the healing of skin and soft tissue;it does not affect the normal hand function rehabilitation training,effectively preventing joint stiffness,tendon adhesions and skin contracture,and can minimize the risk of iatrogenic hand dysfunction;it is of unique advantage in the treatment of traumatic hand skin and soft tissue defects compared with other methods.