医用粘合胶及硅胶敷料抑制小儿先心病术后胸部正中切口瘢痕增生的临床研究

Application of Collagen Medical Glue Sequential Silicone Dressing Inhibition The Scar Hyperplasia of Children with Congenital Heart Disease of Postoperative Chest Midline Incision

目的:探讨医用粘合胶联合硅胶敷料对抑制小儿先心病胸部正中切口手术后瘢痕增生的效果。方法:选取于我院行胸部正中切口先心病矫治术患儿40例,随机分成两组:治疗组20例和对照组20例。治疗组在医用粘合胶治疗1个月后用序贯硅胶敷料治疗5个月;对照组不做特殊处理,在治疗开始后1、3、6和12个月后复查时观察伤口瘢痕形成情况,对比两组患儿治疗后瘢痕外观、质地、厚度、颜色、痛痒等情况。结果:术后的第3、6和12个月两组患儿的瘢痕增生评分相比较,治疗组显著低于对照组,有统计学差异(P<0.05);治疗开始后的第1个月,治疗组患儿的瘢痕增生评分低于对照组,但无统计学差异(P>0.05),所有患者在治疗过程中均未发生明显不良反应。结论:对于先心病术后胸部正中切口患儿的手术切口,使用医用粘合胶序贯硅胶敷料治疗能够有效抑制瘢痕的增生。

Objective To investigate the effect of application of collagen medical glue sequential silicone dressing on the scar of children with congenital heart disease of postoperative chest midline incision. Methods Forty cases of patients with congenital heart disease of postoperative chest midline incision, were divided into two groups randomly： the control group 20 cases and the treatment group （collagen medical glue sequential silicone dressing） contained 20 cases, the treatment group to use collagen medical glue for one month then sequential use silicone dressing for five months ,total six months; the control group without special treatment. To compare the scar appearance, texture, thickness, color, pain and itching between two groups after the therapy began 1, 3, 6 and 12 months. Results 3,6 and 12months after treatment starting, patients in treatment group with scar scores were significantly lower than the control group （P〈0.05）, the first month treatment group of patients with scar score below the control group of patients, but it was no statistically significant （P〉0.05）.All patients had no significant adverse reaction during the course of treatment. Conclusion For children with congenital heart disease surgery chest midline incision scar treatment, the use of medical glue sequential silicone dressing treatment can effectively inhibit scar hyperplasia.