菱形皮瓣转移治疗藏毛窦临床研究

doi:10.3877/cma.j.issn.2095-3224.2018.02.017

目的

评价菱形皮瓣转移术治疗骶尾部藏毛窦的临床疗效。

方法

回顾分析西安马应龙肛肠医院自2015年8月至2017年2月11例采用菱形皮瓣转移术治疗骶尾部藏毛窦的疗效。

结果

11例手术完成顺利，伤口裂开3例（27.27%），皮下血肿1例（9.09%），所有病例无切口感染，伤口痊愈中位时间21 d，术后随访1~18月无复发。

结论

菱形皮瓣转移术是治疗藏毛窦，尤其是复发性藏毛窦理想的手术选择。

关键词: 治疗, 菱形皮瓣, 藏毛窦, 手术

Objective

To evaluate the therapeutic effect of rhomboid flap graft for the pilonidal disease.

Methods

The clinical parameters were analyzed in the 11 patients who had undergone rhomboid flap graft for the pilonidal disease from August 2015 to February 2017, which were collected at the 1st Department of Anorectum, Xi′an Coloproctology Hospital.

Results

Operations were successful in all patients. In our research, there were 3 cases of wound dehiscence (27.27%), 1 case of hematoma (9.09%) and no wound infection. The median healing time is 21 days. 1 patient lost to follow-up, the others, follow-up time ranged from 1 to 18 months, without recurrence.

Conclusions

The rhomboid flap graft technique is a viable alternative for surgical management of pilonidal disease.

Key words: Therapy, Rhomboid flap, Pilonidal disease, Surgery

图6 创口缝合

图7 改良Limberg皮瓣转移切口设计

表1 患者术后临床资料

序号	术式^*	首次大便（d）	尾侧拔管（d）	头侧拔管（d）	下床时间（d）	间断拆线（d）	全部拆线（d）	术后住院（d）	愈合时间（d）	裂开?	张力性水泡	感染	血肿	复发
1	1	8	6	8	8	12	13	14	14	NO	NO	NO	NO	—
2	3	21	5	15	15	11	18	27	40	1	YES	NO	YES	NO
3	2	13	7	9	13	14	20	21	21	NO	NO	NO	NO	NO
4	2^**	15	9	10	15	—	—	21	21	NO	NO	NO	NO	NO
5	2^**	5	6	8	5	—	—	39	41	2	NO	NO	NO	NO
6	2	5	7	11	5	12	19	20	20	NO	NO	NO	NO	NO
7	2	12	5	8	10	13	15	16	16	NO	NO	NO	NO	NO
8	2	16	4	8	8	11	14	15	15	NO	YES	NO	NO	NO
9	2	14	9	11	8	11	16	17	17	NO	NO	NO	NO	NO
10	2	10	7	12	8	14	17	19	28	1	YES	NO	NO	NO
11	2	12	7	NO	10	10	14	14	14	NO	NO	NO	NO	NO
M	—	12	7	10	8	12	17	19	21	?	?	?	?	?

表1 患者术后临床资料

序号	术式^*	首次大便（d）	尾侧拔管（d）	头侧拔管（d）	下床时间（d）	间断拆线（d）	全部拆线（d）	术后住院（d）	愈合时间（d）	裂开?	张力性水泡	感染	血肿	复发
1	1	8	6	8	8	12	13	14	14	NO	NO	NO	NO	—
2	3	21	5	15	15	11	18	27	40	1	YES	NO	YES	NO
3	2	13	7	9	13	14	20	21	21	NO	NO	NO	NO	NO
4	2^**	15	9	10	15	—	—	21	21	NO	NO	NO	NO	NO
5	2^**	5	6	8	5	—	—	39	41	2	NO	NO	NO	NO
6	2	5	7	11	5	12	19	20	20	NO	NO	NO	NO	NO
7	2	12	5	8	10	13	15	16	16	NO	NO	NO	NO	NO
8	2	16	4	8	8	11	14	15	15	NO	YES	NO	NO	NO
9	2	14	9	11	8	11	16	17	17	NO	NO	NO	NO	NO
10	2	10	7	12	8	14	17	19	28	1	YES	NO	NO	NO
11	2	12	7	NO	10	10	14	14	14	NO	NO	NO	NO	NO
M	—	12	7	10	8	12	17	19	21	?	?	?	?	?

图11 间断缝合伤口复查（术后30 d）

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Clinical research of rhomboid flap graft for the pilonidal disease

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Clinical research of rhomboid flap graft for the pilonidal disease