皮肤软组织扩张术在四肢大面积瘢痕修复中的应用效果及患者疼痛影响因素分析

The effect of skin and soft tissue expansion in the repair of large-area scars on extremities and analysis of influencing factors of patient pain

目的研究皮肤软组织扩张术在四肢大面积瘢痕修复中的应用效果及患者疼痛影响因素,为临床治疗该病症提供借鉴。方法回顾性收集2018年5月~2020年9月75例四肢大面积瘢痕患者资料作为研究资料,以年限分组,其中2019年2月至2020年9月患者作为观察组,以2018年值2019年2月患者作为对照组,两组均实施皮肤软组织扩张术,其中观察组扩张倍数增加和注水时间频率增加。比较比较两组患者手术指标情况、扩张情况、治疗有效率和感染率情况。同时分析影响患者疼痛评分的影响因素。结果手术指标观察组在注水时间(t=6.585,P<0.001)、创面愈合时间(t=-8.090,P<0.001)、血运恢复时间(t=-11.581,P<0.001)、疼痛评分(t=-9.588,P<0.001)上都要小于对照组,差异显著,有统计学意义。扩张情况:观察组在扩张倍数上与对照组有差异,有统计学意义(χ^(2)=28.567,P<0.001);但是在扩张器埋置数(χ^(2)=0.01,P=0.597)、扩张器形状选取(χ^(2)=0.245,P=0.885)方面两者差异不大,无统计学意义(P>0.05)。治疗有效率和感染率:观察组感染率为2.6%,对照组为22.2%,差异显著,具有统计学意义(χ^(2)=6.851,P=0.009);观察组治疗有效率为89.7%,对照组治疗有效率为69.4%,差异显著,具有统计学意义(χ^(2)=7.548,P=0.023)。影响因素:影响患者疼痛评分的独立危险因素分别是扩张倍数、感染、注水时间、创面愈合时间。相关性:疼痛评分与扩张倍数(rs=-0.696,P<0.001)、感染(rs=-0.462,P<0.001)、注水时间(rs=-0.569,P<0.001)为负相关关系,与创面愈合时间(rs=0.801,P<0.001)为正相关关系。结论皮肤软组织扩张术在四肢大面积瘢痕修复中的应用效果显著,其中扩张倍数、感染、注水时间、创面愈合时间是影响患者疼痛评分的独立危险因素。

Objective To study the effect of skin soft tissue expansion in the repair of large-area scars on extremities and the influencing factors of patient pain,so as to provide reference for clinical treatment of this disease.Methods The data of 75 patients with extensive scars on extremities from May 2018 to September 2020 were collected retrospectively as research data,grouped by years,of which patients from February 2019 to September 2020 were taken as the observation group,and the value of 2018 was 2019 In February,the patients served as the control group,and both groups underwent skin and soft tissue expansion,in which the expansion multiple of the observation group increased and the frequency of water injection time increased.Compare the two groups of patients with surgical indicators,expansion,treatment efficiency and infection rate.At the same time,the influencing factors that affect the patient’s pain score are analyzed.Results In the observation group of surgical indicators,water injection time(t=6.585,P=0.000),wound healing time(t=-8.090,P=0.000),blood supply recovery time(t=-11.581,P=0.000),pain score(T=-9.588,P=0.000)are smaller than the control group,the difference is significant and statistically significant.Expansion:The observation group is different from the control group in the expansion ratio,which is statistically significant(χ^(2)=28.567,P=0.000);but in the number of dilators embedded(χ^(2)=0.01,P=0.597),the dilator shape is selected(χ^(2)=0.245,P=0.885)There is little difference between the two and there is no statistical significance(P>0.05).Treatment effective rate and infection rate:The infection rate of the observation group was 2.6%and that of the control group was 22.2%,the difference was significant and statistically significant(χ^(2)=6.851,P=0.009);the treatment effective rate of the observation group was 89.7%,and the control group The effective rate of treatment was 69.4%,the difference was significant and statistically significant(χ^(2)=7.548,P=0.023).Influencing factors:The independent risk factors that affect the patient’s pain score are expansion multiple,infection,water injection time,and wound healing time.Correlation:Pain score is negatively correlated with expansion multiple(rs=-0.696,P=0.000),infection(rs=-0.462,P=0.000),and water injection time(rs=-0.569,P=0.000),and has a negative correlation with wound surface The healing time(rs=0.801,P=0.000)is positively correlated.Conclusion Skin and soft tissue expansion is effective in repairing large-area scars on extremities.Expansion times,infection,water injection time,and wound healing time are independent risk factors that affect the pain score of patients.