广西壮、汉族深Ⅱ度烧伤及一期愈合手术切口缝合伤患者伤后瘢痕增生程度变化及相关因素分析

CHANGES OF HYPERTROPHY AND THE RELATED FACTOR ANALYSIS OF DEEP PARTIAL THICKNESS BURN WOUND OR POSTOPERATIVE INCISION SUTURE BETWEEN HAN AND ZHUANG NATIONALITIES IN GUANGXI

目的:研究广西壮、汉族换药愈合未经抗瘢痕治疗的深Ⅱ度烧伤以及一期愈合的手术缝合切口患者,在创面愈合后12个月内瘢痕增生程度的变化情况以及瘢痕增生的影响因素。方法:对广西不同地区壮、汉族伤后3,6,12个月3个时相点439例换药愈合且未经抗瘢痕治疗的深Ⅱ度烧伤及一期愈合手术缝合切口患者伤后瘢痕增生程度进行定量测定以及流行病学资料分析,比较创面愈合后不同时期两种类型损伤瘢痕增生情况以及多种因素与瘢痕增生的相关性。结果:广西壮、汉族烧伤后瘢痕平均增生程度均比同期手术后瘢痕平均增生程度明显(P<0.05),两民族瘢痕同样损伤类型同期比较无差异(P>0.05),两民族同样损伤类型3,6,12个月瘢痕平均增生程度比较差异无统计学意义(P>0.05)。广西壮、汉族人群中,女性手术后瘢痕增生程度均比男性明显(P<0.05),烧伤后瘢痕男性均比女性明显(P<0.05);未婚人群伤后瘢痕增生均比已婚人群明显(P<0.05);有过敏史和有辛辣饮食习惯者比无过敏史和无辛辣饮食习惯者瘢痕明显(P<0.05)。在相关因素分析中,过敏史(r=0.145,P=0.028)和辛辣饮食习惯(r=0.154,P=0.012)与瘢痕增生程度呈正相关。结论:广西壮、汉族烧伤后瘢痕增生程度均比同期手术后瘢痕增生程度明显,两民族瘢痕同样损伤类型同期比较无差异,两民族同样损伤类型在创面愈合后12个月内瘢痕增生程度无明显变化。瘢痕增生程度与性别、婚否以及有无过敏史和辛辣饮食习惯者有关。

Objective：To observed the changes of scar hypertrophic degree and the influence factors in patients with deep partial thickness burn wound or postoperative incision suture in 12 months.The burn wound must be dressing healed without treatment resistant scars and the incision suture should be the first stage healing.Methods：A total of 439 cases of Han and Zhuang nationalities in different areas of Guangxi were randomly selected for the study.The degrees of scar hypertrophy and epidemiology materials were measured and analyzed in 3,6 and 12 months; respectively.The degree of scar hypertrophy in different point times was discussed by contrast,and the relativity between influence factors and scar hypertrophy after the patients＇ wound healing was illustrated.Results：Compared with the group of the first stage healing after operative incision,differences in scar hypertrophy were found in deep partial thickness burn scar （P 〈0.05）.However,it was no difference between the two nationalities in the same period and same kind of injury （P 〉0.05）.It also showed that the degree of scar hypertrophy in both groups in 3,6 and 12 months had no obvious significance.In the two nationalities,the degree of scar hyperplasia was higher in females than in males after operation （P 〈0.05）,but it was lower in females than in males after burn （P 〈0.05）.The degree of scar hyperplasia was also high in unmarried,allergic and spicy food habit patients.Among the influence factors,there was a positive correlation between scar hypertrophy and hypersensitivity history （r =0.145,P =0.028） and spicy food （r =0.154,P =0.012）.Conclusion：The degree of scar hypertrophy in deep partial thickness burn scar is more serious than that of the first stage healing after the incision suture.It is no difference between the two nationalities in the same period and same kind of injury and the degree of scar hypertrophy in both groups during 12 months.The degree of scar hypertrophy is correlation with gender,marital status and presence of allergies and spicy diet.