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目的:探讨应用不同类型的游离桡动脉掌浅支（SPBRA）穿支皮瓣修复指端缺损的临床效果。方法:2013年1月至2018年12月，应用不同类型SPBRA游离穿支皮瓣修复指端缺损38例46指，其中男28例，女10例；年龄17~ 54 (38.5±15.5）岁。指端缺损面积1.5 cm×3.5 cm~ 2.5 cm×5.5 cm。其中双侧游离SPBRA穿支皮瓣修复8例；13指携带掌长肌腱修复；30指皮瓣携带桡神经浅支分支，16指皮瓣未携带神经。皮瓣面积1.6 cm×4.0 cm~ 2.8 cm×6.0 cm,供区均直接缝合。术后对38例进行随访，每个月门诊随访1次，随访时进行皮瓣各项评价指标的测量及记录，并指导患者进行腕关节及手指关节功能锻炼。结果:本组38例术后无血管危象发生，皮瓣均成活。有1例皮瓣远端约有0.5 cm×0.3 cm浅表坏死，经换药后逐渐愈合。随访6~ 24 (14.5±8.5）个月。皮瓣质地柔软，弹性好，无臃肿，肤色接近正常皮肤，感觉功能恢复良好,TPD为5.0~ 8.5 mm，手指关节活动均良好。所有患者在术后6个月时参照《手外科手术学》的皮瓣综合评定标准进行皮瓣综合评价，结果为优42例（91.30%），良3例（6.52%），可1例（2.17%），优良率为97.83%。结论:应用不同类型的游离SPBRA穿支皮瓣修复指端缺损，可以一期修复指掌侧固有动脉、神经及肌腱缺损，简便易行，皮瓣成活满意，手功能恢复好。“,”Objective:To explore the repair of fingertip defects with transplantation of different types of free perforator flaps pedicled with the superficial palmar branch of radial artery (SPBRA).Methods:A retrospective analysis was carried out of the clinical data of 46 fingers from 38 cases [28 males and 10 females, aged 17-54 years with a mean age at (38.5±15.5) years] with tissue defects of fingertips that were repaired with free perforator flaps based on SPBRA, between January, 2013 and December, 2018. The soft tissue defects were 1.5 cm ×3.5 cm to 2.5 cm×5.5 cm. Among them, 8 cases were repaired with bilateral free SPBRA perforator flaps. Thirteen flaps carried long palmar tendon. Thirty flaps carried radial nerve and the other 16 flaps without. The size of flaps was 1.6 cm×4.0 cm- 2.8 cm×6.0 cm. Donor sites were all closed directly. Monthly postoperative follow-up was conducted. All the evalua- tion indexes of flap were measured and recorded. Instructed patients to do wrist and finger joint exercises.Results:All 46 flaps survived. No vascular crisis happened and all skin grafts survived in donor sites. There was 0.5 cm×0.3 cm of distal flap necrosis in 1 case and healed by dress changing. Thirty-eight cases had followed-up for 6 to 24 months. The flaps were soft and elastic, and colours were near to normal. There was no bulkiness. Sensory function re- covered well and TPD was 5.0-8.5 mm. The function and appearance of the finger were good. According to the Oper- ative Hand Surgery Function Evaluation of Flap after 6 months, the result was excellent in 42 cases, good in 3 cases, fair in 1 case, with 97.83% of excellent and good rate.Conclusion:Using different types of free tissue perforator flap based on SPBRA can repair fingertip defect, and reconstruct the defect of digital artery, nerve or tendon in one stage. The operation was simple and easy to do, and can achieved good results with high survival rates and good function recovery.