硅酮凝胶防治面部术后瘢痕增生的临床研究

Clinical research of silicone gel on preventing and treating the postoperative facial scar

目的 观察并评估硅酮凝胶防治面部术后瘢痕增生的临床疗效.方法 将112例患者分成3组,硅酮凝胶组41例,喜辽妥软膏组23例,空白对照组48例.术后3d至6个月常规外用硅酮凝胶或喜辽妥软膏或不予外用药物,以温哥华瘢痕量表为参考,评估各组瘢痕增生及患者的满意度.结果 硅酮凝胶组与喜辽妥软膏组各个时期瘢痕评分差异均无统计学意义（P＞0.05）;硅酮凝胶组与空白对照组术后1、3个月的瘢痕评分差异无统计学意义（P＞0.05）,术后6、12个月的瘢痕评分差异有统计学意义（P＜0.05）;喜辽妥软膏组与空白对照组术后1个月瘢痕评分差异无统计学意义（P＞0.05）,术后3、6、12个月瘢痕评分差异有统计学意义（P＜0.05）.硅酮凝胶组与喜辽妥软膏组术后12个月的满意率差异无统计学意义（P＞0.05）;硅酮凝胶组、喜辽妥软膏组与空白对照组术后12个月满意率差异均有统计学意义（P＜0.05）.结论 术后早期（6个月内）局部外用硅酮凝胶可有效预防瘢痕增生,且可提高患者的满意度.

Objective To observe and assess the clinical effect of silicone gel on preventing and treating the postoperative facial scar. Methods All 112 postoperative facial patients were divided into 3 groups ： 41 ca- ses were in the silicone gel group, 23 in the hirudoid ointment group and 48 in the blank control group. The treatment was performed for 3 days to 6 months. The degree of the scar hyperplasia and satisfaction of the pa- tients was evaluated based on Vancouver Scar Scale. Results There was no difference between silicone gel group and hirudoid ointment group at all stages （ P 〉 0.05）, and so was silicone gel group and blank control group at 1 month and 3 months postoperatively （ P 〉 0.05）, yet the two groups had significant difference at 6 months and 12 months postoperatively （P〈0.05）. There was no difference between hirudoid ointment group and blank control group at 1 month postoperatively （ P〉 0.05）, yet the two groups had significant difference at 3 months, 6 months and 12 months postoperatively （ P 〈 0.05）. The satisfaction at 1 year after operation in both the silicone gel group and hirudoid ointment group had no difference （ P 〉 0.05 ）, yet that in the blank control group had significant difference when compared with silicone gel group and hirudoid ointment group（ P 〈0.05）. Conclusion Silicone gel was effective at the early stage （6 months） on preventing the development of facial scar and improving the patients satisfaction.