摘要
目的研究预扩张胸三角皮瓣修复颈部烧伤瘢痕的临床效果。方法纳入我院收治的48例颈部烧伤瘢痕患者为研究对象,按抽签随机方法将其分为观察组和对照组,各24例,其中对照组实施常规邻近皮瓣修复术,观察组实施预扩张胸三角皮瓣修复术。比较两组患者的术后皮瓣存活率、术后3、6、12个月修复组织挛缩率、术前及术后3、6、12个月的TGF-β1、VEGF水平及术后并发症发生情况。结果观察组30个皮瓣的成活率为100.00%,对照组31个皮瓣的成活率为93.55%,两组的皮瓣存活率比较,差异无统计学意义(P>0.05)。术后6、12个月,两组的修复组织挛缩率均显著高于术后3个月(P<0.05);术后12个月,两组的修复组织挛缩率显著高于术后6个月(P<0.05);术后3、6、12个月,观察组修复组织挛缩率均显著低于对照组(P<0.05)。术前及术后3、6、12个月,两组的TGF-β1、VEGF水平比较,差异无统计学意义(P>0.05);术后,两组的TGF-β1、VEGF水平均显著高于术前,且随着时间地推移呈逐渐增高的趋势(P<0.05)。两组患者的术后并发症总发生率均为12.50%,差异无统计学意义(P>0.05)。结论与常规邻近皮瓣修复术相比,预扩张胸三角皮瓣修复术治疗颈部烧伤瘢痕患者的挛缩率更低,安全性较好。
Objective To study the clinical effect of pre-expanded deltopectoral skin flaps on repairing neck burn scar. Methods A total of 48 patients with neck burn scar enrolled in our hospital were selected as the study objects. The patients were randomly divided into observation group and control group by lottery, with 24 cases in each group. The control group underwent routine adjacent skin flaps repair, while the observation group underwent pre-expanded deltopectoran skin flaps repair. The postoperative survival rate of skin flaps, the contracture rate of repaired tissue at 3, 6, 12 months after the operation, the levels of TGF-β1 and VEGF before the operation and at 3, 6 and 12 months after the operation, occurrence of postoperative complications were compared between the two groups. Results The survival rate of 30 skin flaps in the observation group was 100.00%, while the survival rate of 31 skin flaps in the control group was 93.55%, there was no significant difference in the survival rate of skin flaps between the two groups (P>0.05). At 6 and 12 months after the operation, the contracture rates of repaired tissue in both groups were significantly higher than those at 3 months after the operation (P<0.05). At 12 months after the operation, the contracture rate of repaired tissue in both groups was significantly higher than that at 6 months after the operation (P<0.05). At 3, 6 and 12 months after the operation, the contracture rates of repaired tissue in the observation group were significantly lower than those in the control group (P<0.05). Before the operation and 3, 6 and 12 months after the operation, there were no statistically significant differences in the levels of TGF-β1 and VEGF between the two groups (P>0.05). After the operation, the levels of TGF-β1 and VEGF in both groups were significantly higher than those before the operation, and showed a gradual increase trend with the passing of time (P<0.05). The total incidence of postoperative complications in both groups were 12.50%, with no statistically significant difference (P>0.05). Conclusion Compared with routine adjacent skin flaps repair, pre-expanded deltopectoral skin flaps repair in the treatment of neck burn scar has lower the contracture rate and better safety.
作者
韩悦
李莎
任杰
HAN Yue;LI Sha;REN Jie(Xi'an Central Hospital,Xi'an 710000,China)
出处
《临床医学研究与实践》
2019年第31期57-59,共3页
Clinical Research and Practice
