摘要
目的探讨瘢痕切除联合中厚皮移植整形手术对烧伤愈合后瘢痕畸形患者的影响。方法方便选取2015年6月—2018年12月该院收治的60例烧伤愈合后瘢痕畸形患者,按随机数字表分组。常规方法联合功能锻炼治疗组进行常规方法联合功能锻炼治疗,瘢痕切除联合中厚皮移植整形手术组进行瘢痕切除联合中厚皮移植整形手术。分析比较两组效果;关节活动功能改善时间、关节活动功能恢复正常的时间;并发症。结果瘢痕切除联合中厚皮移植整形手术组手术效果更高,差异有统计学意义﹙χ^2=8.893,P<0.05﹚。常规方法联合功能锻炼治疗组显效、有效、无效、总有效率分别是10例、11例、9例、21例(70.00%),瘢痕切除联合中厚皮移植整形手术组显效、有效、无效、总有效率分别是27例、3例、0例、30例(100.00%)。瘢痕切除联合中厚皮移植整形手术组关节活动功能改善时间、关节活动功能恢复正常的时间﹙4.05±0.41﹚个月、﹙6.01±1.61﹚个月优于常规方法联合功能锻炼治疗组,差异有统计学意义﹙t=5.278、6.784,P<0.05﹚。瘢痕切除联合中厚皮移植整形手术组并发症低于常规方法联合功能锻炼治疗组,差异有统计学意义﹙χ^2=8.923,P<0.05﹚,瘢痕切除联合中厚皮移植整形手术组并发症发生率20.00%(1例皮下血肿,2例小部分皮肤点片状坏死,6个月后出现3例轻度瘢痕挛缩);常规方法联合功能锻炼治疗组并发症发生率43.33%(2例皮下血肿,3例小部分皮肤点片状坏死,6个月后出现6例轻度瘢痕挛缩,2例中度瘢痕挛缩)。结论烧伤愈合后瘢痕畸形患者行瘢痕切除联合中厚皮移植整形手术效果确切,可加速关节功能恢复,减少并发症。
Objective To investigate the effect of scar resection combined with moderate-thickness skin graft surgery on scar deformity after burn healing.Methods Sixty patients with scar deformity after burn healing were convenient selected and enrolled from June 2015 to December 2018.The conventional method combined with the functional exercise treatment group was performed with conventional methods combined with functional exercise treatment,and the scar resection combined with the medium-thickness skin transplantation plastic surgery group was performed with scar resection combined with moderate-thickness skin transplantation.To analyze and compare the effects of the two groups;the time of improvement of joint activity and the time when joint function returned to normal;complications.Results The surgical outcome of the scar resection combined with the mid-thickness skin graft surgery was higher,the difference was statistically significant(χ^2=8.893,P<0.05).The conventional method combined with functional exercise treatment group wereinitial effective,effective,ineffective,and the total effective rate was 10 cases,11 cases,9 cases,21 cases(70.00%),respectively.The scar resection combined with the medium-thickness skin graft surgery group was initial effective,effective,ineffective,and the total effective rate were 27 cases,3 cases,0 cases,30 cases(100.00%)respectively.The time of joint activity improvement and the time to return to normal joint activity of the scar resection combined with the middle-thickness skin grafting surgery group were﹙4.05±0.41﹚months,﹙6.01±1.61﹚months,which was better than the conventional method combined with functional exercise treatment group,the difference was statistically significant﹙t=5.278,6.784,P<0.05﹚.The complication of scar resection combined with moderate-thickness skin graft surgery was lower than that of conventional method combined with functional exercise group,the difference was statistically significant﹙χ^2=8.923,P<0.05﹚.The incidence of complication was 20.00%in 1 case of scar resection combined with moderate-thickness skin graft surgery(1 case of subcutaneous Hematoma,2 cases of small skin flaky necrosis,3 cases of mild scar contracture after 6 months;the complication rate of conventional methods combined with functional exercise group was 43.33%(2 cases of subcutaneous hematoma,3 cases of small skin spots)Necrosis,6 cases of mild scar contracture after 6 months,2 cases of moderate scar contracture).Conclusion The scar resection combined with the mid-thickness skin grafting surgery in patients with scar deformity after burn healing is effective,which can accelerate the recovery of joint function and reduce complications.
作者
朱太君
ZHU Tai-jun(Department of Burn and Plastic Surgery,Pizhou People's Hospital,Pizhou,Jiangsu Province,221300 China)
出处
《中外医疗》
2019年第34期1-2,18,共3页
China & Foreign Medical Treatment
关键词
瘢痕切除
中厚皮移植整形手术
烧伤愈合后瘢痕畸形患者
影响
Scar resection
Moderate-thickness skin graft plastic surgery
Scar deformity after burn healing
Influence
