| 复合骨皮瓣移植联合骨延长修复下肢烧伤伴软组织并骨缺损 |
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投稿时间：2020-02-19
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| 期刊信息：《中国骨伤》2020年，第33卷，第11期，第1063-1067页 |
| DOI：10.12200/j.issn.1003-0034.2020.11.015 |
| 基金项目: |
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| 中文摘要:目的：比较传统腓骨皮瓣联合异体骨移植与复合骨皮瓣移植联合骨延长分期修复治疗下肢烧伤致严重软组织并骨缺损的疗效。方法：回顾分析2015年3月至2018年1月下肢烧伤致严重软组织并骨缺损患者68例，依据治疗方案分为对照组34例与研究组34例。所有患者存在不同程度软组织及骨组织缺损，研究组34例采取复合骨皮瓣移植联合骨延长分期修复治疗，男22例，女12例；年龄32~46（39.18±6.01）岁；受伤至治疗时间（16.69±5.11）h；致伤原因：爆炸伤28例，火器烧伤6例；骨缺损长度（12.10±2.34）cm；左侧16例，右侧18例。对照组34例采取腓骨皮瓣联合异体骨移植治疗，男24例，女10例；年龄31~47（38.93±5.81）岁；受伤至治疗时间（17.10±5.63）h；爆炸伤30例，火器烧伤4例；骨缺损长度（11.96±2.51）cm；左侧19例，右侧15例。所有患者随访6个月，记录两组术前及术后3、6个月肢体功能Fugl-Meyer分值（FMA），术后6个月的治疗满意度、疗效和并发症。结果：肢体功能：术前两组FMA分值间差异无统计学意义（P>0.05），术后3、6个月两组FMA分值较术前增高（P<0.05），且研究组高于对照组（P<0.05）。术后6个月疗效：研究组治疗优良率（94.12%）高于对照组（76.47%）（P<0.05）。术后6个月患者治疗满意度：研究组治疗满意度（94.12%）高于对照组（76.47%）（P<0.05）。并发症：研究组并发症发生率（14.71%），对照组（26.47%），差异无统计学意义（P>0.05）。。结论：联合采取复合骨皮瓣移植及骨延长分期修复治疗下肢烧伤致严重软组织并骨缺损，可取得良好治疗效果，改善患者肢体功能，治疗满意度较高，且具有一定安全性。 |
| 【关键词】外科皮瓣 骨延长术 下肢 烧伤 软组织损伤 |
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| Composite bone and skin flap transplantation combined with bone lengthening for repairing lower limb burn with soft tissue and bone defect |
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| ABSTRACT Objective: To compare the effect of traditional fibula flap combined with allogeneic bone transplantation and composite bone flap transplantation combined with bone lengthening in staged repair of severe soft tissue and bone defect caused by lower limb burn. Methods: Total 68 patients with severe soft tissue and bone defect caused by lower limb burn from March 2015 to January 2018 were retrospectively analyzed,and they were divided into control group (34 cases) and study group (34 cases) according to the treatment plan. All patients had different degrees of soft tissue and bone tissue defects. In the study group,34 patients were treated with composite bone flap transplantation combined with bone lengthening. There were 22 males and 12 females; the age ranged from 32 to 46(39.18±6.01) years; the time from injury to treatment was (16.69±5.11) h;28 cases were caused by explosion injury and 6 cases were caused by firearm burn; the length of bone defect was (12.10±2.34) cm;and 16 cases were on the left side of affected limb 18 cases were on the right side. In the control group,there were 24 males and 10 females,aged 31 to 47 (38.93 ±5.81) years;the time from injury to treatment was(17.10±5.63) h;the causes of injury were explosive injury in 30 cases and firearm burn in 4 cases; the length of bone defect was (11.96±2.51) cm;19 cases were on the left side and 15 cases on the right side. All patients were followed up for 6 months. The FMA scores before operation and 3 and 6 months after operation,treatment satisfaction,curative effect and complications of the two groups were recorded. Results: Limb function:there was no significant difference in FMA scores between the two groups before operation(P>0.05),and the FMA scores of the two groups were higher than those before operation 3 and 6 months after operation(P<0.05),and the FMA scores of the study group were higher than those of the control group(P<0.05). At 6 months after operation:the excellent and good rate of the study group(94.12%) was higher than that of the control group (76.47%)(P<0.05),the treatment satisfaction of the study group (94.12%) was higher than that of the control group(76.47%)(P<0.05). Complications:the incidence of complications in the study group (14.71%) was higher than that in the control group (26.47%) (P>0.05). Conclusion: the combined use of composite bone flap transplantation and bone lengthening staged repair in the treatment of severe soft tissue and bone defect caused by lower limb burn can achieve good therapeutic effect,improve limb function,and have high treatment satisfaction and certain safety. |
| KEY WORDS Surgical flaps Bone lengthening Lower extremity Burns Soft tissue injuries |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 金婕.复合骨皮瓣移植联合骨延长修复下肢烧伤伴软组织并骨缺损[J].中国骨伤,2020,33(11):1063~1067 |
| 英文格式: | JIN Jie.Composite bone and skin flap transplantation combined with bone lengthening for repairing lower limb burn with soft tissue and bone defect[J].zhongguo gu shang / China J Orthop Trauma ,2020,33(11):1063~1067 |
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