陈立　陈钰颍　兰伟斌

[摘要] 目的 探討四肢烧伤创面患者行筋膜皮瓣及筋膜瓣治疗及效果。 方法 纳入2016年2月～2017年11月80例四肢烧伤创面患者以数字表法分组。对照组进行腹部带蒂皮瓣治疗，观察组行筋膜皮瓣及筋膜瓣治疗。比较两组治疗优良率、皮瓣存活率；皮瓣质地评分、皮瓣美观度评分、皮瓣弹性评分；干预前后患者肢体功能FMA评分、生存质量SF-36评分；溃疡发生率、伸屈功能受限发生率。 结果 观察组治疗优良率、皮瓣存活率高于对照组（P<0.05）；观察组皮瓣质地评分、皮瓣美观度评分、皮瓣弹性评分优于对照组（P<0.05）；干预前两组肢体功能FMA评分、生存质量SF-36评分相近（P>0.05）；干预后观察组肢体功能FMA评分、生存质量SF-36评分优于对照组（P<0.05）。观察组溃疡及伸屈功能受限发生率低于对照组（P<0.05）。 结论 四肢烧伤创面患者行筋膜皮瓣及筋膜瓣修复的治疗及效果确切，可提高皮瓣存活率和治疗效果，皮瓣外观和质地均良好，有利于改善肢体伸屈功能和提升患者生存质量，减少溃疡、伸屈功能受限的发生率。

[关键词] 四肢烧伤创面患者；筋膜皮瓣及筋膜瓣；生存质量

[中图分类号] R644 [文献标识码] B [文章编号] 1673-9701（2018）23-0094-03

Application effect of fascio-cutaneous flap and adipofascial flap in the repair of burn wounds of limbs

CHEN Li1 CHEN Yuying2 LAN Weibin1 ZOU Guoping1 XIE Jianhong1 ZENG Yuanyuan1

1.Department of Orthopaedics，Longyan First Hospital Affiliated to Fujian Medical University，Longyan 364000，China；2.Department of Nephrology， Longyan First Hospital Affiliated to Fujian Medical University，Longyan 364000，China

[Abstract] Objective To investigate the treatment and effect of fasciocutaneous flap and fascial flap in patients with limb burns. Methods A total of 80 patients with burns of limbs from February 2016 to November 2017 were included and grouped according to the digital table method. The control group was treated with abdominal pedicle flaps， and the observation group was treated with fasciocutaneous flaps and fascial flaps. The excellent and good rate， the survival rate of flaps， flap texture score， flap aesthetic rating， and the elasticity score of the flaps between the two groups were evaluated. The limb function FMA scores and quality of life SF-36 scores before and after the intervention were compared. The incidence of ulceration and the rate of limited extension and flexion were evaluated. Results The excellent and good rate of treatment and the survival rate of the flap in the observation group were higher than those of the control group（P<0.05）. The skin texture score， skin aesthetic score and flap elasticity score of the observation group were better than those of the control group（P<0.05）. The FMA scores and quality of life SF-36 scores of the limbs before intervention were similar（P>0.05）. After the intervention， the FMA scores and the quality of life SF-36 scores of the observation group were better than those of the control group（P<0.05）. The incidence of ulceration and the limited extension and flexion function in the observation group were lower than those in the control group（P<0.05）. Conclusion The fasciocutaneous flap and fascial flap in the repair of limb burn wounds in patients has definite treatment effect， which can improve flap survival rate and therapeutic effect， with good appearance and texture of the flaps， and it helps to improve limb extension and flexion and improve the quality of life， and reduce the incidence of ulcers and limited extension and flexion.

[Key words] Limbs burn wound patients；Fascio-cutaneous flap and adipofascial flap； Quality of life

四肢烧伤创面严重的情况下通常可出现皮肤严重缺损和肌腱、骨关节、血管、等深部结构暴露的现象，需给予皮瓣进行修复，以促进患肢恢复原有的功能和外观。目前用于四肢烧伤创面皮肤缺损修复的皮瓣类型比较多，不同皮瓣在成活率、质地、弹性、外观等方面存在一定的差异[1-2]，本研究纳入2016年2月～2017年11月80例四肢烧伤创面患者以数字表法分组，分析了四肢烧伤创面患者行筋膜皮瓣及筋膜瓣的治疗及效果，现报道如下。

1 资料与方法

1.1 一般资料

选择2016年2月～2017年11月80例四肢烧伤创面患者以数字表法分组。观察组男29例，女11例；年龄22～54岁，平均（36.78±1.41）岁。肢体近端烧伤有22例，肢体远端烧伤18例。烧伤面积占体表面积1%～5%，平均（2.78±1.423）%。对照组男28例，女12例；年龄22～54岁，平均（36.71±1.45）岁。肢体近端烧伤21例，肢体远端烧伤19例。烧伤面积占体表面积1%～5%，平均（2.76±1.41）。……