罗远国+覃万安+吴家昌

[摘要] 目的 探讨存在静脉功能障碍的患者应用复合组织瓣修复组织缺损的疗效。方法 收集2013年2月～2014年12月在解放军第三〇三医院接受复合组织瓣修复组织缺损手术12例患者的临床资料，术后观察患者皮瓣成活率及术后随访观察患者的肢体功能恢复情况。 结果 本组12例皮瓣全部成活，创面修复良好。术后随访18个月，患者创面均恢复良好，修复后肢体功能外观形态良好，无压痛，肢体功能及外观恢复基本满意。 结论 复合组织皮瓣修复存在静脉功能障碍患者的组织缺损疗效值得肯定，皮瓣成活率高，能够进一步降低患者伤残率及使患者肢体功能得到最大恢复，是修复此类患者组织缺损的安全、有效的手术方式，可以较好地恢复肢体功能。

[关键词] 静脉功能障碍；复合组织皮瓣；组织缺损

[中圖分类号] R658 [文献标识码] A [文章编号] 1673-7210（2017）01（c）-0095-04

[Abstract] Objective To investigate the effect composite tissue flap repairing venous dysfunction in patients with tissue defect. Methods The clinical data of 12 patients received composite tissue flap repairing venous dysfunction operation in No.303 Hospital of PLA during February 2013 to December 2014 were collected， flap surival rate and follow-up limbs recover situation of patients were observed. Results Total flaps of 12 patients survived sucessfully well and wound recovered well. After 18 months follow-up， the wound recovered fine， limbs fuction and appearance were well， absence of tenderness， limbs fuction and appearance recovered satisfactorily. Conclusion The treatment of composite tissue flap repairing venous dysfunction operation is worthy pertinent， with a high surival rate， it can reduce the rate of maim and mostly recover the fuction of patients' limbs， it is the most safe and effective treatment of repairing such kind of patients' tissues， and it is best to repair fuction of patients' limbs.

[Key words] Dysfuction of vein； Composite tissue flap； Tissue defect

皮瓣（skin flap）是指带有自身的血液供应，同时包含皮肤组织的活的组织块。皮瓣是外科组织瓣中（surgical flap）的一种，而同时连带着同源血供的骨、肌腱及其他组织的皮瓣则称为复合组织皮瓣，其主要应用于修复创面、功能重建及改善外形的外科领域中。创伤修复是整个外科领域最重要的问题之一[1-2]。而静脉功能障碍性疾病是周围血管疾病中最常见的一类疾病，存在这类病变的患者，因无法重建血运，创伤后组织缺损、血运差、感染等因素，是导致修复皮瓣不能很好成活的主要因素。

随着城乡机动化、工业化日益发展，各种事故造成的创伤发生率逐年升高，且随着目前中国逐步进入老龄化社会，老年患者也随之有所增长[3]。……