目的:探讨应用游离皮瓣修复小儿四肢严重创伤后软组织缺损的临床效果.方法:选择2013年9月至2015年9月本院接诊的90例四肢创伤性软组织损伤患儿为研究对象,通过就诊顺序分为2组,单号为观察组,双号为对照组,每组45例.观察组患儿采用游离皮瓣修复术,对照组应用传统皮肤移植术.比较两组手术时间、术中出血量、住院时间及术后不良事件发生率,并进行6个月~1年的随访,记录皮瓣成活率.结果:观察组患儿手术时间、术中出血量、住院时间均少于对照组,差异具有统计学意义(P<0.05);观察组血管危象、70h静脉危象发生率分别为2.22%和4.44%,低于对照组的20.00%和24.44%,差异具有统计学意义(P<0.05);随访结果显示,观察组皮瓣成活率为91.11%,高于对照组的66.67%(P<0.05).结论:在小儿四肢创伤性组织损伤中使用游离皮瓣修复效果显著,该术式创伤小、术后不良事件低、皮瓣成活高,可满足其对四肢的美观需求,临床应用价值高.%Objective To study effect of free flap repair of soft tissue defect in children after severe limb trauma. Methods Ninety children of traumatic soft tissue injury of extremities who received therapy from September 2013 to September 2015 in our hospital were selected. They were divided into two groups by visiting order, singular as the observation group, even as the control group, each group of 45 cases. The observation group was treated with free flap repair. The control group was treated with conventional skin grafting. The operation time, intraoperative blood loss, hospital stay and postoperative adverse events were compared between the two groups, and followed up for 6 months-1 years, the flap survival rate was compared. Results The operation time, the amount of bleeding and the length of stay in the observation group were less than those in the control group, the difference was statistically significant(P<0.05). The incidence of vascular crisis and 70h venous crisis in the observation group was 2.22% and 4.44%, which was significantly lower than that of the control group at 20.00% and 24.44%(P<0.05). The follow-up showed that the flap survival rate in the observation group was 91.11%, which was significantly higher than that of the control group 66.67%(P<0.05). Conclusion Free flap repair is well for traumatic soft tissue injury of extremities in children. The operation has the advantages of small trauma, low postoperative adverse events, high flap survival, to meet its aesthetic needs of the limbs. It has high clinical value.
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