联合A型肉毒毒素治疗对急性阑尾炎术后切口瘢痕增生的影响

Effects of Combined Botulinum Toxin Type A Treatment on Postoperative Incision Scar Hyperplasia after Appendectomy

目的:探索联合A型肉毒毒素使用是否可以减轻急性阑尾炎手术术后切口瘢痕增生。方法:选取2018年3月2018年12月在北京丰台右安门医院行急性阑尾炎切除手术的80例患者,随机分为观察组和对照组,观察组在常规缝合后切口边缘注射A型肉毒毒素,对照组仅进行常规缝合,分别于术后1周、2周、1月和3月进行随访,采用视觉模拟评分法(VAS)评估术后疼痛情况;采用温哥华瘢痕量表对瘢痕的色泽、厚度、血管分布及柔软度4个指标判断瘢痕增生情况;比较两组的上述指标,记录并比较两组的术后切口愈合时间和术后满意度情况。结果:术后1天,两组患者各项指标差异无统计学意义,术后1周、2周、1月及3月,观察组的VAS评分明显低于对照组;术后1周,观察组的瘢痕厚度和血管分布及术后2周、1月和3月的瘢痕色泽、厚度、血管分布及柔软度评分均低于对照组;观察组术后切口愈合时间短于对照组,且观察组患者满意度高于对照组,差异均有统计学意义(P均<0.05)。结论:急性阑尾炎切除手术术后行切口缝合时,联合A型肉毒毒素使用在一定程度上可以减轻切口瘢痕增生。

Objective To explore whether the use of botulinum toxin type A could reduce the wound scar hyperplasia after appendectomy.Methods Eighty patients who underwent appendectomy in Beijing Fengtai Youanmen hospital from March 2018 to December 2018 were randomly divided into the observation group and the control group.The observation group was combined with the use of botulinum toxin A during routine suture,The control group was only subjected to conventional sutures.Follow-up was performed at 1 week,2 weeks,1 month,and 3 months after operation.The visual analogue scale(VAS)was used to evaluate the postoperative pain.The Vancouver Scar Scale was used to evaluate the scar color,thickness,blood vessel distribution,and softness,which were used to determine the hyperplasia of the scar.The postoperative incision healing time and postoperative satisfaction survey were recorded.Results There was no significant difference in patients’basic information between the two groups on the first day after operation.The VAS scores in the observation group at 1 week,2 weeks,1 month,and 3 months after operation were significantly lower than those in the control group;And the scores of blood vessel distribution,and the scar color,thickness,blood vessel distribution,and softness in observation group at 2 weeks,1 month,and 3 months after operation were all lower than those of the control group;The satisfaction degree of postoperative incision recovery in the group was higher than that in the control group,all differences were statistically significant(all P<0.05).Conclusion The combination of botulinum toxin type A with incision suture after appendectomy could alleviate scar hyperplasia of the incision to a certain extent.