不同敷料贴治疗胸腹部微创术后增生性瘢痕的临床效果研究

Effect of different dressing on hypertrophic scar after thoracoabdominal minimally invasive surgery

目的研究使用不同敷料贴治疗胸腹部微创术后增生性瘢痕的临床效果。方法166例胸腹部微创手术后增生性瘢痕患者,采用随机数字表法分为瘢痕贴组(62例)、硅酮敷料组(56例)及对照组(48例)。对照组创面完全愈合后仅使用纱布和弹性绷带,不添加任何辅助治疗及护理措施;硅酮敷料组创面完全愈合后使用硅酮敷料治疗;瘢痕贴组创面完全愈合后使用医用瘢痕贴治疗。治疗6个月后,比较三组治疗效果及温哥华瘢痕量表(VSS)评分。结果瘢痕贴组与硅酮敷料组治疗总有效率分别为95.16%、91.07%,均高于对照组的75.00%,差异有统计学意义(χ^(2)=9.338、4.882,P=0.002、0.027<0.05);而瘢痕贴组与硅酮敷料组治疗总有效率比较差异无统计学意义(χ^(2)=0.779,P=0.378>0.05)。瘢痕贴组和硅酮敷料组色泽、血管分布、柔软程度、厚度评分以及总分均低于对照组,差异有统计学意义(P<0.05);瘢痕贴组色泽和柔软程度评分低于硅酮敷料组,差异有统计学意义(P<0.05)。结论瘢痕贴可有效抑制胸腹部微创术后皮肤增生性瘢痕,且在消除色泽和改善柔软程度方面优于硅酮敷料。

Objective To study the clinical effect of different dressing on hypertrophic scar after thoracoabdominal minimally invasive surgery.Methods A total of 166 patients with hypertrophic scar after thoracoabdominal minimally invasive surgery were divided into medical scar patch group(62 cases),silicone dressing group(56 cases)and control group(48 cases)according to random numerical table.In the control group,only gauze and elastic bandage were used after wound healing without any auxiliary treatment and nursing measures;in silicone dressing group,silicone dressing was used after wound healing;in medical scar dressing group,medical scar dressing were used after wound healing.6 months after treatment,the therapeutic effect and Vancouver scar scale(VSS)score of the three groups were compared.Results The total effective rate of medical scar patch group and silicone dressing group were 95.16%and 91.07%,which were higher than 75.00%of the control group,and the difference was statistically significant(χ^(2)=9.338,4.882;P=0.002,0.027<0.05).There was no statistically significant difference in total effective rate between medical scar patch group and silicone dressing group(χ^(2)=0.779,P=0.378>0.05).The scores of color,vascular distribution,soft degree and thickness and total score in medical scar patch group and silicone dressing group were lower than those in control group,and the difference was statistically significant(P<0.05).The scores of color and softness in medical scar patch group were lower than those in silicone dressing group,and the difference was statistically significant(P<0.05).Conclusion Medical scar patch can effectively inhibit hypertrophic scar after thoracoabdominal minimally invasive surgery,and medical scar patch is better than silicone dressing in color and softness of hypertrophic scar.