压力疗法持续时间对其抑制瘢痕增生疗效的观察

Relationship of time and effects of pressure therapeutics on the scar hyperplasia

目的探讨应用弹力绷带压力疗法抑制瘢痕增生的疗效。方法对烧伤愈合后患者肢体进行弹力绷带压力疗法抑制瘢痕增生,按照加压持续时间分为半天加压组(n=30,每天持续加压12 h左右)和全天加压组(n=30,每天持续加压约24 h),2组均采用相同的压力、起始时间、包扎方法,应用激光多普勒血流图像诊断技术分别测量加压前后4个时相(T_1为加压前,T_2为加压治疗后2个月,T_3为加压治疗后6个月,T_4为加压治疗后12个月)的瘢痕组织表面血流灌注量(LDPI值),观察相关临床指标如瘢痕硬度、厚度、色泽、充血及痛痒感等的变化,比较压力疗法持续时间对其抑制瘢痕增生效果的影响。结果半天加压组LDPI值分别为T_1(1.84±0.31)V,T_2(1.85±0.26)V,T_3(1.79±0.32)V,T_4(1.81±0.25)V,加压治疗前后各时相比较差异均无统计学意义(P>0.05),各项临床观察指标均无明显变化;全天加压组LDPI值分别为T_1(1.81±0.26)V,T_2(1.78±0.36)V,T_3(1.54±0.22)V,T_4(1.47±0.23)V,其中连续加压6个月以后瘢痕开始变平变软,色泽变淡,痛痒感减退,充血减轻,LDPI值明显下降,与同组内T_1、T_2及半天加压组T_3、T_4比较差异均有统计学意义(P<0.05)。结论采用弹力绷带每天24 h连续加压疗法抑制瘢痕增生,治疗6个月以上,才能收到较好的抑制瘢痕增生的效果。

Objective To study the relationship of lime and therapeutic effect of the elastic pressure bandage therapeutics on scar hyperplasia. Methods Sixty patients were screened and divided into two groups, the half-day group （continuously pressuring about 12 h） and the whole-day group （pressuring about 24 h）, according to the pressure time. The same pressure and method were used and the tissue blood flow volume of the scar surface was measure by laser Doppler perfusion imaging（LDPi） at 4 phases before the pressuring and after pressure 2,6 and 12 months of the two groups. Results The LDPI of the four half-day groups were （ 1.84±0.31 ） V, （ 1.85±0.26） V, （ 1.79±0. 32） V and （ 1.81±0.25 ） V, respectively. There were no statistic changes among them. The LDPI of the four whole- day groups were （ 1.81±0.26 ） V, （ 1.78±0.36 ） V, （ 1.54±0.22 ） V and （ 1.47±0.23 ） V, respectively. The LDPI decreased obviously after 6 months（ P 〈 0.05）. Conclusion Elastic pressure bandage therapy of 24 hours a day and continued more than 6 months was a effective way of scar therapy.