摘要
目的探讨改良美容缝合术联合CO_(2)点阵激光治疗面部挫裂伤患者的疗效及其对伤口美观度修复效果的影响。方法选取2023年4~12月南阳市第二人民医院收治的86例面部挫裂伤患者作为研究对象,根据隐藏式信封法分为观察组和对照组各43例,对照组患者采用传统清创缝合术治疗,观察组患者采用改良美容缝合术联合CO_(2)点阵激光治疗,1次/月,共治疗2个月。比较两组患者的缝合时间、伤口愈合时间和缝合美观度评分;治疗后(缝合术后3个月)比较两组患者的温哥华瘢痕量表(VSS)评分和并发症发生率,以及治疗前后的心理状况[焦虑自评量表(SAS)和抑郁自评量表(SDS)]和生活质量[采用生活质量评定量表(SF-36)评价],同时比较两组患者治疗后的满意度。结果观察组患者的缝合时间为(10.97±1.38)min,明显长于对照组的(7.83±1.16)min,伤口愈合时间为(4.02±0.63)d,明显短于对照组的(5.38±0.88)d,而缝合美观度评分为(9.40±1.18)分,明显高于对照组的(7.10±1.05)分,差异均有统计学意义(P<0.05)。治疗后,观察组患者VSS评分中的色泽、血管分布、厚度、柔软度评分分别为(1.12±0.09)分、(1.08±0.14)分、(1.55±0.16)分、(6.06±0.57)分,明显低于对照组的(1.68±0.23)分、(1.54±0.18)分、(1.93±0.22)分、(8.61±0.76)分,差异均有统计学意义(P<0.05)。观察组患者的术后并发症发生率为6.98%,明显低于对照组的25.58%,差异有统计学意义(P<0.05);治疗后,观察组患者的SAS、SDS得分分别为(36.56±3.79)分、(39.88±3.66)分,明显低于对照组的(45.36±4.03)分、(48.83±4.52)分,差异均有统计学意义(P<0.05)。治疗后,观察组患者SF-36量表中的躯体功能、心理功能、健康状况与社会功能维度得分分别为(72.86±6.50)分、(73.55±6.59)分、(70.25±6.54)分、(70.30±6.62)分,明显高于对照组的(63.11±5.82)分、(62.15±5.70)分、(64.61±5.33)分、(65.22±5.32)分,差异均有统计学意义(P<0.05)。观察组患者对治疗的满意度为95.35%,明显高于对照组的76.74%,差异有统计学意义(P<0.05)。结论改良美容缝合术联合CO_(2)点阵激光疗法治疗面部挫裂伤能够促进患者创面愈合,提高缝合美观度,减轻术后瘢痕严重程度,降低并发症风险,并同时改善患者负面心理症状及生活质量,患者满意度良好,具有可靠的推广价值。
Objective To investigate the efficacy of modified cosmetic suturing combined with CO_(2) fractional laser in treating patients with facial contused lacerations and its impact on wound aesthetic repair.Methods Eighty-six patients with facial contused lacerations admitted to Nanyang Second People's Hospital from April to December 2023 were selected as study subjects.They were divided into an observation group and a control group using the hidden envelope method,with 43 patients in each group.Patients in the control group received traditional debridement and suturing,while those in the observation group received modified cosmetic suturing combined with CO_(2) fractional laser therapy,once a month,for a total of 2 months.The suturing time,wound healing time,and aesthetic suture score were compared between the two groups.After treatment(3 months post-suturing),the Vancouver Scar Scale(VSS)score,complication rate,psychological status(Self-rating Anxiety Scale[SAS]and Self-rating Depression Scale[SDS]),and quality of life(assessed using the Short Form-36 Health Survey Questionnaire[SF-36])before and after treatment were compared between the two groups.Patient satisfaction after treatment was also compared.Results The suturing time in the observation group was(10.97±1.38)min,significantly longer than(7.83±1.16)min in the control group.The wound healing time in the observation group was(4.02±0.63)d,significantly shorter than(5.38±0.88)d in the control group.The aesthetic suture score in the observation group was(9.40±1.18)points,significantly higher than(7.10±1.05)points in the mentation,vascularity,thickness,and pliability in the observation group were(1.12±0.09)points,(1.08±0.14)points,(1.55±0.16)points,and(6.06±0.57)points,respectively,significantly lower than(1.68±0.23)points,(1.54±0.18)points,(1.93±0.22)points,and(8.61±0.76)points in the control group(P<0.05).The postoperative complication rate in the observation group was 6.98%,significantly lower than that in the control group(25.58%),with a statistically significant difference(P<0.05).After treatment,the SAS and SDS scores in the observation group were(36.56±3.79)points and(39.88±3.66)points,respectively,significantly lower than(45.36±4.03)points and(48.83±4.52)points in the control group(P<0.05).After treatment,the scores for physical functioning,role-emotional,general health perceptions,and social functioning in the SF-36 scale in the observation group were(72.86±6.50)points,(73.55±6.59)points,(70.25±6.54)points,and(70.30±6.62)points,respectively,significantly higher than(63.11±5.82)points,(62.15±5.70)points,(64.61±5.33)points,and(65.22±5.32)points in the control group(P<0.05).The treatment satisfaction rate in the observation group was 95.35%,significantly higher than 76.74%in the control group(P<0.05).Conclusion Modified cosmetic suturing combined with CO_(2) fractional laser therapy for facial contused lacerations can promote wound healing,improve suture aesthetics,reduce postoperative scar severity,lower the risk of complications,and simultaneously improve patients'negative psychological symptoms and quality of life,with good patient satisfaction and reliable promotion value.
作者
占克松
廖晓南
刘晨阳
ZHAN Ke-song;LIAO Xiao-nan;LIU Chen-yang(Department of Plastic and Cosmetic Surgery,Nanyang Second People's Hospital,Nanyang 473000,Henan,CHINA)
出处
《海南医学》
2025年第24期3559-3565,共7页
Hainan Medical Journal
基金
河南省医学科技攻关计划项目(编号:LHGJ20200867)。
