甲状腺手术切口大小对术后瘢痕美观的影响

Impact on Postoperative Scar Aesthetics of Incision Length in Thyroidectomy

目的评价甲状腺小切口手术后瘢痕的美观效果是否优于大切口。方法选取2008年3月至2008年6月期间笔者所在医院30例接受甲状腺手术的连续患者并随机均分为2组,小切口组切口长度为6 cm,大切口组为9 cm。3年后采用患者与观察者瘢痕评价量表(POSAS)与温哥华瘢痕量表(VSS)对切口瘢痕进行评价;同时拍摄数码照片并由研究非相关人员进行独立评价。结果 2组均分别有13例患者完成了3年随访。2组患者的一般临床特征差异无统计学意义(P>0.05)。小切口组与大切口组患者的瘢痕总体评分分别为(2.5±1.9)分与(2.2±1.5)分,2组间比较差异无统计学意义(P=0.55);其他的瘢痕评价量表(包括VSS评分、PSAS评分以及OSAS评分),2组间比较差异也均无统计学意义(P>0.05)。研究非相关人员对瘢痕数码照片的评价差异也无统计学意义(P>0.05)。结论从本组有限的病例看,甲状腺手术中应用较大切口并不降低患者对瘢痕的满意度。

Objective To evaluate if performing thyroidectomy through small incision has any notable aesthetic impact on patients compared with larger incision.Methods Thirty consecutive patients underwent thyroidectomy were enrolled from March 2008 to June 2008 in this prospective randomized pilot study.The incision length was 6 cm in the small incision group and 9 cm in the larger incision group.After 3 years follow-up,the scar aesthetics were evaluated by patients and surgeons using the Patient and Observer Scar Assessment Scale（POSAS）,Vancouver Scar Scale（VSS）,respectively.Digital photographs about scars were taken and assessed by non-research related viewers.Results There were 13 cases who received scar aesthetic assessment in both groups.The demographic characteristics of both groups were comparative.The overall patients’ satisfactions for the small incision group and the larger incision group were（2.5±1.9）scores and（2.2±1.5）scores,respectively（P=0.55）.There were no significant differences in scar assessment scale score as for other scar assessment scales（including VSS score,PSAS score,and OSAS score）between the two groups.The evaluation of digital photographs about scars by non-research related viewers was no significant difference（P〉0.05）.Conclusion Larger cervical scar in thyroidectomy does not decrease patients’ satisfaction with their scar results.