皮肤软组织扩张术修复瘢痕畸形的临床应用分析

A Clinical Research about the Application of Skin and Soft Tissue Expansion in the Treatment of Scars

目的:回顾性分析近年来皮肤软组织扩张术在治疗瘢痕上的临床应用与变化,为临床进一步应用提供理论基础。方法:选择2011年1月-2016年12月于笔者科室行皮肤软组织扩张术治疗瘢痕患者122例,共埋置153枚扩张器,依年份分组,其中2014年1月-2016年12月就诊的64例为观察组,2011年1月-2013年12月就诊的58例为对照组。对患者的基础资料及术后情况进行对比分析。结果:两组患者在性别、年龄、瘢痕所占体表面积、扩张器埋置数目、部位、形状及其额定容积、注水周期的选择上,差异均无统计学意义(P>0.05);观察组大多数患者采用了超量扩张方法,扩张倍数(注水量/额定容积)1倍以上的患者52例(81.2%),高于对照组的51.7%,组间比较差异有统计学意义(P<0.05);相关性分析结果显示,在适当范围内扩张倍数与并发症发生率呈负相关,注水周期与并发症发生率呈正相关(P<0.05)。结论:皮肤软组织扩张术修复瘢痕畸形,多选用超量扩张法可有效降低并发症发生率。

Objective To analyze the changes of plastic and reconstructive surgery of scars using skin and soft tissue expander in recent years,provide a theoretical basis for further clinical application.Methods From January 2011 to December 2016,122 cases of scar patients were treated by skin soft tissue dilation in our department,a total of 153 expanders were embedded.These cases were divided into two groups by treatment year,64 cases in the observed group from January 2014 to December 2016,58 cases in the control group from January 2011 to December 2013.The patient＆#39;s basic data and postoperative situation were compared and analyzed.Results Factors such as gender,age,number and type of expanders,anatomic site,total scar surface area and injection period showed no significant statistical difference（P〉0.05）.Most of the patients in the observation group adopted over expansion,there were 52 patients（81.2%）with over expansion multiples of more than 1 times,higher than 51.7%in the control group,and the difference between groups was statistically significant（P〈0.05）.The correlation analysis showed that the expansion multiple was negatively correlated with the incidence of complications in the appropriate range,and the water injection cycle was positively correlated with the incidence of complications（P〈0.05）.Conclusion Skin and soft tissue expansion is used to repair scar deformity,and over expansion can effectively reduce the incidence of complications.