序贯缝粘术对颅颌面皮肤挫裂伤效果的分析

Effect of sequential suture and adhesion on craniomaxillofacial skin contusion and laceration

目的探讨序贯缝粘术对颅颌面皮肤挫裂伤的效果。方法 2018年1月至2020年7月, 河南科技大学第一附属医院急诊科收治颅颌面皮肤挫裂伤患者189例(男134例、女55例, 26~38岁), 分为序贯缝粘组66例、美容缝合组63例、常规缝合组60例。比较3个组手术时间, 术后24 h视觉模拟评分(VAS), 6个月时温哥华瘢痕量表(VSS)及不良反应发生率, 评估疗效及满意度。结果序贯缝粘组手术时间为(10.67±1.26) min, 显著少于美容缝合组(18.91±1.38) min与常规缝合组(17.96±1.43 ) min(均P<0.05)。序贯缝粘组术后24 h VAS为(3.11±1.01)分, 较美容缝合组及常规缝合组显著降低(t=3.84, P<0.05)。序贯缝粘组术后6个月VAS为(1.18±0.21)分, 显著小于美容缝合组(3.78±1.01)分(t=2.13, P<0.05)及常规缝合组(5.98±1.06)分(t=1.21, P<0.01)。序贯缝粘组总有效率为96.5%, 显著高于美容缝合组(85.7%, χ^(2)=8.41, P<0.05)及常规缝合组(56.1%, χ^(2)=8.62, P<0.01);美容缝合组总有效率显著高于常规缝合组(t=4.12, P<0.05)。序贯缝粘组术后伤口感染率、裂开率均低于美容缝合组及常规缝合组(χ^(2)=6.13, P<0.01)。序贯缝粘组满意率(99.0%)显著高于美容缝合组(89.1%)及常规缝合组(71.3%, χ^(2)=4.15, P<0.05);美容缝合组满意率显著高于常规缝合组(χ^(2)=3.92, P<0.05)。结论序贯缝粘术治疗颅颌面部皮肤挫裂伤操作简单, 效果较好, 并发症少, 患者满意度高, 值得临床应用。

Objective To investigate the effect of sequential suture and adhesion on craniomaxillofacial skin contusion and laceration.Methods A total of 189 patients with craniomaxillofacial skin contusion and laceration(CMFSCL)were randomly divided into three groups:66 cases in SSA group,63 cases in CS group and 60 cases in TS group.Operation time,visual analogue scale(VAS),Vancouver scar scale(VSS)and adverse reactions incidence were compared and analyzed between the three groups.Effect and satisfactory scale were evaluated.Results Operation time in SSA group(10.67±1.26)min was significantly less than that in CS(18.91±1.38)min and TS group(17.96±1.43)min(P<0.05).VAS in SSA group 24 h post-operation(3.11±1.01)was significantly lower than that in CS and TS group(P<0.05).VSS in SSA group 6 months post-operation(1.18±0.21)was significantly lower than that in CS(3.78±1.01)(P<0.05)and TS group(5.98±1.06)(P<0.01).Total effective rate of SSA group(96.5%)was significantly higher than that in CS(85.7%)(P<0.05)and TS group(56.1%)(P<0.01);total effective rate in CS group was significantly higher than that in TS group(P<0.05).Infection and dehiscence rates in SSA group were lower than those in CS and TS group(P<0.01).Satisfactory rate of SSA group(99%)was significantly higher than that of CS(89.1%)and TS group(71.3%)(P<0.05);the satisfactory rate of CS group was significantly higher than that of TS group(P<0.05).Conclusions Sequential suture and adhesion technique is simple and effective for craniomaxillofacial skin contusion and laceration,which is worthy of clinical promotion.