摘要
目的研究Winograd术联合改良缝合技术及健康宣教治疗嵌甲型甲沟炎的临床疗效。方法2021年11月至2022年12月东部战区总医院皮肤科就诊的84例嵌甲型甲沟炎患者(Mozena分级Ⅱa级及以上),采用Winograd术联合改良缝合技术治疗及进行健康宣教,术后随访6~12个月。疼痛视觉模拟评分随时间的变化采用重复测量的方差分析,4点口述分级评分法评估的疼痛等级资料分析采用Kruskal-Wallis H检验。结果84例嵌甲型甲沟炎患者在随访期间,治愈78例(92.9%),改善3例(3.6%),复发3例(3.6%)。术后患者疼痛程度在1个月和3个月时较术前均显著降低(H=8.65、8.64,均P<0.001);术后疼痛视觉模拟评分在1个月时为(0.44±0.09)分,在3个月时为(0.16±0.04)分,均较术前(6.18±0.24)分显著降低(均P<0.001)。术后4例发生了感染,经换药后痊愈。结论Winograd术联合改良缝合技术及健康宣教治疗嵌甲型甲沟炎疗效确切,术后复发率低,术式和缝合技术简单实用。
Objective To investigate the clinical efficacy of the Winograd procedure combined with a modified suturing technique and health education in the treatment of ingrown toenail-induced paronychia.Methods From November 2021 to December 2022,84 patients with ingrown toenail-induced paronychia(stages IIA and above according to the Mozena classification)were collected from the Department of Dermatology,General Hospital of Eastern Theater Command.All patients received the Winograd procedure combined with a modified suturing technique and health education,and were followed up for 6-12 months after surgery.Changes in the visual analog scale(VAS)pain scores over time were analyzed using repeated measures analysis of variance,and pain intensity data assessed using a 4-point verbal rating scale were analyzed using the Kruskal-Wallis H test.Results During the follow-up period,78 out of 84(92.9%)patients were completely cured,3(3.6%)achieved improvement,and 3(3.6%)experienced relapse.The pain intensity was significantly reduced at 1 month and 3 months after operation compared with that before operation(H=8.65,8.64,both P<0.001);the VAS pain scores were 0.44±0.09 and 0.16±0.04 points at 1 month and 3 months after operation retrospectively,which were both significantly lower than the preoperative scores(6.18±0.24 points,both P<0.001).Four cases developed local infections,and were cured after dressing changes.Conclusion The Winograd procedure combined with a modified suturing technique and health education was effective for the treatment of ingrown toenail-induced paronychia,with a low recurrence rate after surgery,and the operative and suturing techniques were simple and practical.
作者
刘海波
陈军
孔庆涛
桑红
Liu Haibo;Chen Jun;Kong Qingtao;Sang Hong(Department of Dermatology,General Hospital of Eastern Theater Command,Nanjing 210002,China;Department of Dermatology,the Fourth Affiliated Hospital of Nanjing Medical University,Nanjing 210031,China)
出处
《中华皮肤科杂志》
CAS
CSCD
北大核心
2024年第3期258-260,共3页
Chinese Journal of Dermatology
基金
江苏省皮肤病学创新团队项目(CXTDA2017038)。
关键词
嵌甲
甲沟炎
伤口缝合技术
外科手术
Winograd术
Nails
ingrown
Paronychia
Wound closure techniques
Surgical procedures
operative
Winograd procedure