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醫(yī)學(xué)免費論文:甲板和甲床部分切除術(shù)治療頑固性嵌甲96例分析
【摘要】 目的探討甲板和甲床部分切除術(shù)治療頑固性嵌甲的臨床效果。方法96例頑固性嵌甲患者采用甲板和甲床部分切除術(shù)進(jìn)行治療。96例患者中75例曾拔甲2次，21例曾拔甲3次。結(jié)果96例患者中83例獲得隨訪，隨訪時間為1~24個月，平均隨訪10個月，83例患者均未見嵌甲復(fù)發(fā)，有3例在切口近側(cè)角出現(xiàn)小的無癥狀甲刺。結(jié)論甲板和甲床部分切除術(shù)治療頑固性嵌甲較單純拔甲有明顯的優(yōu)勢。
【關(guān)鍵詞】 嵌甲; 甲板; 甲床; 拔甲
The application of the germinal matrix, nail bed and nail plate ablation to cure the relapse onychogryphosis
ZHANG Hua, DENG Qiang醫(yī).學(xué)全.在.線網(wǎng)站m.52667788.cn
(Department of Orthopedics, Fifth Affiliated Hospital, Xinjiang Medical University,Urumqi 830011, China)
Abstract: ObjectiveTo summarize the efficiency evaluation of the germinal matrix, nail bed and nail plate ablation in the relapse onychogryphosis. MethodsThe clinical data of 96 patients with the relapse onychogryphosis, who were operated in the method of the germinal matrix, nail bed and nail plate ablation from 2006 to 2008 year, were retrospectively analyzed. 75 cases of them were excised whole nail to twice and 21 cases of the 96 patients were excised whole nail to three times. ResultsEighty three cases of the 96 patients were followed up for 1~24 months, average 10 months. The 83 cases did not have relapse onychogryphosis, but 3 cases grew a little spur of nail in proximal corner of excision, who did not have any symptoms. ConclusionThere was a great advantage of the germinal matrix, nail bed and nail plate ablation in the relapse onychogryphosis compared with the simple, whole nail excision.
Key words: onychogryphosis; nail plate; nail bed; nail excision
嵌甲是因為甲外側(cè)緣過度生長而嵌入甲溝的軟組織中，造成局部皮膚的破潰，皮膚表面的細(xì)菌、真菌進(jìn)入開放性傷口，引起甲溝局部炎癥、疼痛，繼發(fā)感染、膿腫和肉芽組織形成，致病菌多為金黃色葡萄球菌，可激發(fā)真菌、霉菌感染。頑固性嵌甲是在拔甲后嵌甲復(fù)發(fā)、再次引起局部感染。頑固性嵌甲處理不當(dāng)時常會并發(fā)化膿性趾頭炎、骨髓炎，單純拔甲治療嵌甲復(fù)發(fā)率高達(dá)73%[1]，Murray等[2]報道單純拔甲嵌甲復(fù)發(fā)率為64%，二次拔甲后復(fù)發(fā)率增加到68%，單純拔甲治療頑固性嵌甲效果更差。我科于2006~2008年采用甲板和甲床部分切除術(shù)治療頑固性嵌甲96例，效果良好，現(xiàn)報道如下。
1 資料與方法
1.1 一般資料
96例患者中男性56例，女性40例。年齡13~72歲，平均37歲。75例曾于外院拔甲2次,21例曾拔甲3次。合并甲溝炎87例，合并糖尿病5例，合并真菌感染9例，合并管形趾甲6例。
