CAJ | 학술논문

目的比较游离生理皮瓣、筋膜蒂皮瓣、静脉皮瓣、皮神经营养皮瓣术后皮瓣的颜色、温度、张力及毛细血管充盈消失在不同时段变化情况,为临床治疗提供依据.方法选择手部组织缺损需行皮瓣移植修复的患者221例,按照不同皮瓣移植组织分为4组,其中游离生理皮瓣组50例,筋膜蒂皮瓣组66例,静脉皮瓣组57例,皮神经营养皮瓣组48例.采用围手术期现场调查的方法,比较4组皮瓣在术后不同时段颜色、温度、张力及毛细血管充盈消失的变化情况.结果 4组患者皮瓣血循环情况比较,游离生理皮瓣组灰白发生率20％、暗红发生率38％、极度肿胀发生率32％、毛细血管充盈消失发生率8％,均低于其他3组,差异有统计学意义(x2值分别为20.64,49.90,36.99,36.16;P ＜0.01).结论 4类皮瓣应重点关注术后48 h内血液循环变化情况,皮瓣灰白观察期可缩短至术后2h,游离生理皮瓣毛细血管充盈消失可缩短至术后12 h,筋膜蒂皮瓣在术后7d内各项指标需全程观察.
목적 비교유리생리피판、근막체피판、정맥피판、피신경영양피판술후피판적안색、온도、장력급모세혈관충영소실재불동시단변화정황,위림상치료제공의거.방법 선택수부조직결손수행피판이식수복적환자221례,안조불동피판이식조직분위4조,기중유리생리피판조50례,근막체피판조66례,정맥피판조57례,피신경영양피판조48례.채용위수술기현장조사적방법,비교4조피판재술후불동시단안색、온도、장력급모세혈관충영소실적변화정황.결과 4조환자피판혈순배정황비교,유리생리피판조회백발생솔20％、암홍발생솔38％、겁도종창발생솔32％、모세혈관충영소실발생솔8％,균저우기타3조,차이유통계학의의(x2치분별위20.64,49.90,36.99,36.16;P ＜0.01).결론 4류피판응중점관주술후48 h내혈액순배변화정황,피판회백관찰기가축단지술후2h,유리생리피판모세혈관충영소실가축단지술후12 h,근막체피판재술후7d내각항지표수전정관찰.
Objective To compare the color,temperature,tension and capillary filling in different flaps repair surgery,including free physiological flap,fascial pedicle skin flap,venous skin flap and cutaneous neurotrophic skin flap,so as to provide some directions for clinical observation.Methods From March 2011 to December 2011,totals of 221 patients with 223 flaps were involved in this study.They were divided into four groups:free physiological flap group(n =50),fascial pedicle skin flap group(n =66),venous skin flap group (n =57),cutaneous neurotrophic skin flap group (n =48).The peri-operation investigation was adopted,and the color,temperature,tension and capillary filling in different flaps after operation were observed and compared.Results In free physiological flap group,the incidence of grey and dark red respectively was 20％and 38％,and the rate of tension bullae and disappearing of capillary filling respectively was 32％ and 8％,which was significantly lower than that in others groups (x2 =20.64,49.90,36.99,36.16,respectively;P ＜0.01).Conclusions The blood circulation change must be paid more attention within 24 hours after operation in all the four flap.The observation of grey stage could be shortened to 2 hours,and the disappearing of capillary filling could be 12 hours.The four index of blood circulation of fascial pedicle skin flap must be observed within 7days after operation.