目的：对比足跟软组织缺损患者传统手术和显微外科术后的预后变化，探讨不同术式后患者的心理变化。方法：按照临床表现1∶3配对设计的原则，连续收集我院2012年10月至2013年10月骨科因足跟软组织缺损入院手术患者104名患者，其中实验组(XMP)26例(男16名，女10名)，对照组(NXMP)78例(男48名，女30名)。统计两组患者的基础疾病包括心脑血管病等危险因素，从移植的组织符合足跟的功能要求程度、足跟解剖结构的完整性恢复程度、移植组织血供情况以及整体移植等情况比较两组患者的生理功能预后情况；并采用90项症状清单(SCL-90)和抑郁自评量表(self-rating depression scale，SAS)、焦虑自评量表(self-rating depression scale，SDS)测量每组患者的心理变化情况。结果：1)两组患者在一般的临床资料上无明显差异，具有可比性(P=0.383>0.05)。2)各组患者心理变化情况比较：SCL-90和SAS、SDS评分结果显示，两组患者在手术前均有不同程度心理障碍，对两组手术前各因子进行均数差异检验两组间条件差异无统计学意义(P均>0.05)。手术后对两组患者进行SCL-90和SAS、SDS评分，结果表明实验组较对照组的各项得分差异均具有统计学意义(P<0.05)，实验组患者的心理应激状态较对照组明显减轻。结论：显微外科修复术可以有效的改善患者的心理应激，具有重要的临床应用价值。
Microsurgical repair improve mental function in patients with heel soft tissue defects
Objective: To compare the prognosis changes of traditional heel surgery with microsurgery postoperative in heel soft tissue defects patients, and explore the application value of microsurgical repair in the patient. Methods: According to the principle of matching the design of the clinical manifestations of 1:3, continuously collected the heel of orthopedic surgery patients admitted soft tissue defects (25~65 years old) in our hospital from October 2012 to October 2013, a total of 104 patients were selected, of which 26 cases in experimental group (XMP group: male 16, female 10), 72 cases in control group (NXMP group: male 48, female 30). Statistics include two groups of patients underlying diseases, such as cardiovascular disease risk factors etc. Compared the physiological functions prognosis of two groups patients from the transplanted tissue meets the functional requirements of the heel, completeness degree of recovery heel anatomy, blood supply of the transplanted tissue transplantation and the overall situation; and adopted a list of 90 symptoms (SCL-90), the self-rating depression scale (SAS), self-rating anxiety scale (SDS) to measure psychological changes in both group patients. Results: 1) There were no significant difference of general clinical data in the two groups of patients (P=0.383>0.05); 2) Comparison of the changes of mental: SCL-90 and SAS, SDS scores showed that both groups of patients had varying degrees of psychological disorders before surgery, but there were no significant differences (P>0.05) between the two groups. There were statistically significant differences between the two groups after surgery (P<0.05). Psychological stress in the experimental group was significantly lower than that of the control group. Conclusion: The microsurgical reconstructive surgery not only can effectively improve the soft tissue defects in patients with heel physiological functional outcome, but also reduce the patient's psychological stress. Microsurgical repair surgery has important clinical value in patients with soft tissue defects of the heel.