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医学免费论文:甲板和甲床部分切除术治疗顽固性嵌甲96例分析
【摘要】 目的探讨甲板和甲床部分切除术治疗顽固性嵌甲的临床效果。方法96例顽固性嵌甲患者采用甲板和甲床部分切除术进行治疗。96例患者中75例曾拔甲2次，21例曾拔甲3次。结果96例患者中83例获得随访，随访时间为1~24个月，平均随访10个月，83例患者均未见嵌甲复发，有3例在切口近侧角出现小的无症状甲刺。结论甲板和甲床部分切除术治疗顽固性嵌甲较单纯拔甲有明显的优势。
【关键词】 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医.学全.在.线网站www.med126.com
(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
嵌甲是因为甲外侧缘过度生长而嵌入甲沟的软组织中，造成局部皮肤的破溃，皮肤表面的细菌、真菌进入开放性伤口，引起甲沟局部炎症、疼痛，继发感染、脓肿和肉芽组织形成，致病菌多为金黄色葡萄球菌，可激发真菌、霉菌感染。顽固性嵌甲是在拔甲后嵌甲复发、再次引起局部感染。顽固性嵌甲处理不当时常会并发化脓性趾头炎、骨髓炎，单纯拔甲治疗嵌甲复发率高达73%[1]，Murray等[2]报道单纯拔甲嵌甲复发率为64%，二次拔甲后复发率增加到68%，单纯拔甲治疗顽固性嵌甲效果更差。我科于2006~2008年采用甲板和甲床部分切除术治疗顽固性嵌甲96例，效果良好，现报道如下。
1 资料与方法
1.1 一般资料
96例患者中男性56例，女性40例。年龄13~72岁，平均37岁。75例曾于外院拔甲2次,21例曾拔甲3次。合并甲沟炎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。
