不同扩张器置入术对颈胸部瘢痕的治疗效果比较  

Comparison of the efficacy of different expander implant surgery in the treatment of cervical chest scar

作　　者：杨荣强[1] 王常印[1] 张豫峰[2] 孟庆楠[1] 高娅[1] 王晓博[1] Imran Khan 刘建红 崔正军[1] Yang Rongqiang;Wang Changyin;Zhang Yufeng;Meng Qingnan;Gao Ya;Wang Xiaobo;Imran Khan;Liu Jianhong;Cui Zhengjun(Department of Burn and Repair Reconstruction Surgery,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450002,China;Department of laparoscopy,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450002,China;The Rockets Army General Hospital of PLA,Beijing 100820,China)

机构地区：[1]郑州大学第一附属医院烧伤与修复重建外科,河南郑州450002 [2]郑州大学第一附属医院微创外科,河南郑州450002 [3]中国人民解放军火箭军总医院礼士路门诊部,北京100820

出　　处：《河南医学研究》2018年第13期2310-2313,共4页Henan Medical Research

基　　金：国家自然科学基金联合基金项目(U1604188)

摘　　要：目的对比观察不同扩张器置入术对颈胸部瘢痕的治疗效果。方法以郑州大学第一附属医院烧伤与修复重建外科2012年3月至2015年8月入院选择扩张器置入手术治疗的23例颈胸部瘢痕患者作为研究对象,均接受手术治疗,根据手术方式分为腔镜组(20个扩张器)、微创组(20个扩张器)、长切口组(20个扩张器),记录3组手术时间、术中出血量、术后引流量、住院时间、术后并发症发生情况、术中注水量和术后首次注水量时间。结果腔镜组手术时间长于微创组和长切口组;腔镜组术中出血量及术后引流量少于微创组与长切口组;腔镜组住院时间短于微创组及长切口组,差异有统计学意义(P<0.05)。3组切口感染、切口裂开及扩张器外露并发症发生率比较,差异无统计学意义(P>0.05)。腔镜组与微创组术中注水量多于长切口组,腔镜组术中注水量多于微创组,差异有统计学意义(P<0.05)。腔镜组与微创组术后首次注水时间短于长切口组,腔镜组术后首次注水时间短于微创组,差异有统计学意义(P<0.05)。结论与传统手术方式比较,腔镜下皮肤软组织扩张器置入手术时间相对较长,但组织损伤小,止血充分,可减少术中及术后出血量,同时腔镜下皮肤软组织扩张器置入可实现术中大量注水及术后及早注水,促进患者术后恢复,缩短住院时间。Objective To observe and compare the clinical efficacy of different expander implant surgery in the treatment of cervical chest scar. Methods A total of 23 patients with neck or chest scar hospitalized to be treated with expander implantation in Department of Burn and Repair Reconstruction Surgery of the First Affiliated Hospital of Zhengzhou University from March 2012 to August 2015 were selected as the study subjects. All of them underwent surgery, and were divided into the laparoscopy group （20 expanders）, minimally invasive incision group （20 expanders）, and conventional incision group （20 expanders）. The surgery duration, intraoperative blood loss and hospitalization duration and the incidence of postoperative complications, intraoperative water injection and first time of water injection postoperation were recorded. Results Surgery duration was significantly longer in laparoscopy group than in minimally invasive incision group and conventional incision group, intraoperative blood loss and postoperative drainage volume were significantly lower in laparoscopy group than conventional incision group and minimally invasive incision group, and hospitalization duration was significantly shorter in laparoscopy group than in minimally invasive incision group and conventional incision group, and differences were statistically significant（ P 〈0.05 ）. The differences among the incidences of incision infection, incision dehiscence and expander exposure in three groups were no statistically significant （ P 〉0.05 ）. Intraoperative water injection of laparoscopy group and minimally invasive group was significantly higher than long incision group, and intraoperative water injection of laparoscopy group was higher than that of the minimally invasive group, and differences were statistically significant（ P 〈0.05 ）. First time of water injection postoperation of laparoscopy group and minimally invasive group was shorter than long incision group, and first time of water injection postoperation o

关 键 词：皮肤扩张 腔镜 微创 

分 类 号：R751[医药卫生—皮肤病学与性病学]