摘要
目的探讨携带正中神经掌皮支的游离桡动脉掌浅支皮瓣修复手指软组织缺损中皮瓣及供区感觉恢复问题。方法2014年1月至2016年6月，携带正中神经掌皮支的游离桡动脉掌浅支皮瓣修复手指软组织缺损12例，正中神经掌皮支与指神经缝合，定期测定皮瓣的2 g触觉、5 g痛觉、30 g压觉以及两点辨别觉，记录皮瓣供区侧和健侧正中神经掌皮支区的静止两点辨别觉，采用配对t检验，观察皮瓣感觉恢复及供区的感觉恢复情况。结果术后门诊随访6~18个月，皮瓣全部成活。术后2个月约83.3%的患者出现压觉，术后3个月后全部出现压觉；术后3个月约91.7%的患者出现触觉，术后4个月全部出现触觉；术后4个月约91.7%的患者出现痛觉，术后5个月后全部出现痛觉。术后6个月皮瓣静止两点分辨觉平均8.3 mm，而皮瓣供区侧和健侧正中神经掌皮支区的两点辨别觉分别为（12.08±2.15）mm和（10.58±2.11）mm，差异无统计学意义（P〉0.05）。正中神经掌皮支支配区术后的感觉恢复情况：S4 2例，S3^＋ 9例，S3 1例，恢复良好。结论携带正中神经掌皮支的游离桡动脉掌浅支皮瓣修复手指软组织缺损，皮瓣感觉恢复好，供区感觉逐渐恢复，无明显影响。
ObjectiveTo explore the sensation recovery of superficial palmar branch of the radial artery flap with palmar branch of median nerve and donor site.MethodsFrom January, 2014 to June, 2016, 12 cases of finger soft tissue defects were repaired with superficial palmar branch of the radial artery flap with palmar branch of median nerve. The 2 g tactile sensation, 5 g pain sensation, 30 g pressure sensation and static two-point discrimination（S2-PD） of the flap was tested regularly. The S2-PD of the palmar cutaneous branch of the median nerve were recorded respectively on the affected side and the unaffected side. The results were applied comparative t-test to perform statistical analysis, to observe the sensory recovery of the flap and donor site.ResultsThe flaps survived. Twelve cases was followed-up for 6-18 months. The pressure sensation of about 83.3% of patients recovered after 2 months and 100% of patients recovered after 3 months. The tactile sensation of about 91.7% of patients recovered after 3 months and 100% of patients recovered after 4 months. The pain sensation of about 91.7% of patients recovered after 4 months of and 100% of patients recovered after 5 months. S2-PD of the flap was the average of 8.3 mm in 6 months after operation. There were no significant differences in the S2-PD between the affected group[ （12.08±2.15） mm] and unaffected group[ （10.58±2.11） mm]（P〉0.05）. And the sensory recovery of the control area of the palmar branch of the median nerve was S4 in 2 cases, S3＋ in 9 cases, and S3 in 1 case. The sensory recovery was good.ConclusionSuperficial palmar branch of the radial artery flap with palmar branch of median nerve can be used repair the skin defect of the fingers. The flap has a good sensery recovery, and the sensation of the donor area is gradually restored.
作者
荣存敏
李印龙
王芳
徐宝强
张清林
张志
王洪军
韩清銮
Rong Cunmin;Li Yinlong;Wang Fang;Xu Baoqiang;Zhang Qinglin;Zhang Zhi;Wang Hongjun;Han Qingluan(Department of Hand and Foot Surgery,Affiliated Hospital of Jining Medical University,Jining,Shangdong Province 272029,China)
出处
《中华显微外科杂志》
CSCD
北大核心
2018年第5期446-449,共4页
Chinese Journal of Microsurgery
基金
山东省医药卫生科技发展计划项目（2017WS337）
济宁市科技局项目（2014jnwk08）
济宁医学院附属医院”苗圃”科研课题（MP-2014-025）
关键词
桡动脉掌浅支皮瓣
正中神经掌皮支
手指
感觉重建
Superficial palmar branch of radial artery flap
Palmar branch of median nerve
Figer
Sensation reconstruction
