妊娠型腹壁松弛整复术的临床效果及预后分析

Clinical efficacy and prognosis of abdominoplasty in postpartum women with abdominal wall relaxation

目的探讨妊娠型腹壁松弛的特点、治疗策略及治疗效果。方法自2018年1月至2020年10月,四川省医学科学院四川省人民医院整形外科对20例妊娠型腹壁松弛患者行腹壁松弛整复术,观察腹壁整形手术前后腹壁美容效果、并发症情况,根据温哥华瘢痕评估量表(vancouver scar scale,VSS)评估术后6个月的瘢痕情况,根据BODY-Q问卷评估患者术后的满意度。结果2例患者术后出现局部皮瓣远端伤口愈合不良,经换药后愈合,愈合后3~6月短期瘢痕增生。所有患者获随访12~24月,平均15个月。腹壁形态良好,腹围及腹部皮下脂肪较术前改善(P<0.05),远期瘢痕增生不明显。患者的满意率为95%。结论对于妊娠型腹壁松弛患者,通过收紧腹壁肌肉联合切除中下腹壁冗余皮肤的整形外科手术,术后腹壁塑形效果较好,并发症发生率较低,瘢痕隐蔽,可获得较满意的疗效。

Objective To explore the characteristics,treatment strategy and efficacy of abdominal wall relaxation in postpartum women.Methods The clinical data of 20 postpartum women with abdominal wall relaxation from January 2018 to October 2020 were retrospectively analyzed.The cosmetic efficacy of abdominal wall before and after abdominoplasty and complications were observed.The scar at 6 months after surgery was evaluated by Vancouver Scar Scale(VSS).The patient satisfaction after surgery was analyzed by BODY-Q.Results Two patients developed poor wound healing of distal part of local flap and healed after dressing change.The short-term scar hyperplasia from 3 to 6 months was observed.All patients were followed-up for 12 to 24 months,with an average of 15 months.The shape of abdominal wall was good,and the abdominal circumference and abdominal subcutaneous fat were improved after surgery(P<0.05).The long-term scar hyperplasia was not obvious.The patient satisfaction was 95%.Conclusion For postpartum women with abdominal wall relaxation,the abdominoplasty by tightening abdominal wall muscles combined with redundant skin excision of the middle and lower abdominal wall can achieve good abdominal shape,low complication rate,hidden scar and satisfactory efficacy.