吉林医学
吉林醫學
길림의학
JILIN MEDICAL JOURANL
2014年
25期
5554-5555,5556
,共3页
卢晖%王文刚%吴慧玲%罗壬满
盧暉%王文剛%吳慧玲%囉壬滿
로휘%왕문강%오혜령%라임만
手外伤%甲床%缺损%修复
手外傷%甲床%缺損%脩複
수외상%갑상%결손%수복
Hand trauma%Nail bed%Defect%Repair
目的：探讨急诊手外伤甲床缺损多种修复方法的个性化选择的临床疗效。方法：根据急诊手外伤甲床缺损情况，综合患者条件及要求，进行个性化手术方法的选择，对182例手外伤甲床缺损患者分别采用甲床断层转位修复、足趾甲床断层切取游离移植（包括拇甲瓣）和指骨钻孔、VSD负压封闭引流术的方法，急诊行手外伤甲床缺损的修复。结果：本组182例，行甲床断层转位修复共74例，72例甲床成活并愈合，2例甲床部分成活，成活率为97.3%，采用足趾甲床断层切取游离移植（包括拇甲瓣）共46例，45例甲床成活，1例因并发感染甲床未成活，成活率为97.8%，应用指骨钻孔、VSD负压封闭引流术修复甲床共62例，61例甲床完全愈合，1例甲床未完全愈合，经换药后完全愈合，成活率为98.4%，经以上修复方法成活的甲床组织生长良好，再经换药一周左右均愈合并形成甲床组织。住院时间13~18 d，平均15.5 d，随访时间3~6个月，甲床血供好，均可见指甲生长，外观良好，功能满意。结论：综合甲床缺损情况、患者条件及要求选择最佳的个性化修复方法，对于基层手外科医院面对急诊手外伤甲床缺损的快速有效地处理有着重要意义。
目的：探討急診手外傷甲床缺損多種脩複方法的箇性化選擇的臨床療效。方法：根據急診手外傷甲床缺損情況，綜閤患者條件及要求，進行箇性化手術方法的選擇，對182例手外傷甲床缺損患者分彆採用甲床斷層轉位脩複、足趾甲床斷層切取遊離移植（包括拇甲瓣）和指骨鑽孔、VSD負壓封閉引流術的方法，急診行手外傷甲床缺損的脩複。結果：本組182例，行甲床斷層轉位脩複共74例，72例甲床成活併愈閤，2例甲床部分成活，成活率為97.3%，採用足趾甲床斷層切取遊離移植（包括拇甲瓣）共46例，45例甲床成活，1例因併髮感染甲床未成活，成活率為97.8%，應用指骨鑽孔、VSD負壓封閉引流術脩複甲床共62例，61例甲床完全愈閤，1例甲床未完全愈閤，經換藥後完全愈閤，成活率為98.4%，經以上脩複方法成活的甲床組織生長良好，再經換藥一週左右均愈閤併形成甲床組織。住院時間13~18 d，平均15.5 d，隨訪時間3~6箇月，甲床血供好，均可見指甲生長，外觀良好，功能滿意。結論：綜閤甲床缺損情況、患者條件及要求選擇最佳的箇性化脩複方法，對于基層手外科醫院麵對急診手外傷甲床缺損的快速有效地處理有著重要意義。
목적：탐토급진수외상갑상결손다충수복방법적개성화선택적림상료효。방법：근거급진수외상갑상결손정황，종합환자조건급요구，진행개성화수술방법적선택，대182례수외상갑상결손환자분별채용갑상단층전위수복、족지갑상단층절취유리이식（포괄무갑판）화지골찬공、VSD부압봉폐인류술적방법，급진행수외상갑상결손적수복。결과：본조182례，행갑상단층전위수복공74례，72례갑상성활병유합，2례갑상부분성활，성활솔위97.3%，채용족지갑상단층절취유리이식（포괄무갑판）공46례，45례갑상성활，1례인병발감염갑상미성활，성활솔위97.8%，응용지골찬공、VSD부압봉폐인류술수복갑상공62례，61례갑상완전유합，1례갑상미완전유합，경환약후완전유합，성활솔위98.4%，경이상수복방법성활적갑상조직생장량호，재경환약일주좌우균유합병형성갑상조직。주원시간13~18 d，평균15.5 d，수방시간3~6개월，갑상혈공호，균가견지갑생장，외관량호，공능만의。결론：종합갑상결손정황、환자조건급요구선택최가적개성화수복방법，대우기층수외과의원면대급진수외상갑상결손적쾌속유효지처리유착중요의의。
Objective To evaluate a variety of emergency hand trauma nail bed defect repair methods of the clinical curative effect of individual choice. Method According to the emergency hand trauma nail bed defect situation,comprehensive patient conditions and require-ments,personalize the choice of surgical methods,nail bed defect in 182 cases of hand trauma patients with nail bed fault dislocation repai-ring foot nails bed fault cut free transplantation( including thumb nail flap)and finger the VSD closed negative pressure drainage drilling method,the emergency line of hand trauma nail bed defect repair. Results Group 182 examples,line nail bed fault dislocation repair,a total of 74 cases,72 cases of nail bed survival and healed,2 cases of nail bed part of survival,the survival rate was 97. 3%,taking free transplan-tation using foot nail bed fault( including the thumb nail flap),a total of 46 cases,45 cases of nail bed survival,1 case of nail bed did not survive through concurrent infection,the survival rate was 97. 8%,and application of finger bone drilling the VSD closed negative pressure drainage to repair nail bed,a total of 62 cases,61 cases of nail bed healed completely,1 case of nail bed not completely heal,healed com-pletely after dressing,the survival rate was 98. 4%,more than the repair methods of tissue survival of nail bed was good,then through apply-ing a week or so were healing and formation of nail bed organization 13 ~ 18 days of hospital stay,average hospital stay 15. 5 days,follow-up of 3 ~ 6 months time,the nail bed good blood supply,were visible nails. Conclusion Comprehensive nail bed defect of patients con-dition and requirement to choose the best personalized repair methods,for grassroots hospitals in the face of nail bed defect of hand trauma emergency quickly and efficiently handle has important significance.
