医用粘合胶及硅胶敷料对小儿先心病术后胸部正中切口瘢痕增生的抑制效果分析  

Clinical analysis of scar hyperplasia after chest median incision in children with congenital heart disease

作　　者：刘娜[1] 张川[1] 杨磊[1] 柳磊[2] 谢萌[1] Liu Na;Zhang Chuan;Yang Lei;Liu Lei;Xie Meng(Department of Plastic Surgery,Third Hospital,Hebei Medical University,Shijiazhuang 050051,China;Department of Cardiac Surgery,Third Hospital,Hebei Medical University,Shijiazhuang 050051,China)

机构地区：[1]河北医科大学第三医院整形外科,河北省石家庄市050051 [2]河北医科大学第三医院心脏外科,河北省石家庄市050051

出　　处：《临床小儿外科杂志》2019年第1期45-48,共4页Journal of Clinical Pediatric Surgery

基　　金：河北省2016年度医学科学研究重点课题计划(编号:20160595)

摘　　要：目的探讨医用粘合胶及硅胶敷料抑制小儿先心病术后胸部正中切口瘢痕增生的效果。方法选取河北医科大学第三医院接受胸部正中切口先心病矫治术的患儿160例,遵循随机化原则分为4组,其中A组为医用粘合胶治疗组,B组为硅胶敷料治疗组,C组为医用粘合胶序贯硅胶敷料治疗组,D组为对照组,每组各40例。分别于治疗后1、3、6、12个月观察伤口瘢痕形成情况,采用温哥华瘢痕评定量表对瘢痕色泽、血管分布、厚度、柔软度情况进行评分,并进行统计学分析。结果从不同时间段的治疗结果来看,A、B、C、D组瘢痕增生评分均随观察时间的延长而增加,其中A、B、D组各时间段两两间瘢痕评分差异均有统计学意义(P <0. 05),而C组治疗后第6、12个月与治疗前相比差异有统计学意义(P <0. 05);从不同组别来看,治疗后第1个月,4组患儿瘢痕增生评分差异无统计学意义(P> 0. 05);治疗后第3、6、12个月,A、B和C组患儿瘢痕增生评分均显著低于D组(P <0. 05);治疗后第3、6、12个月,C组患儿瘢痕增生评分显著低于A和B组(P <0. 05);但A、B两组间差异无统计学意义(P> 0. 05);治疗过程中患儿均未出现显著不良反应。结论采用医用粘合胶序贯硅胶敷料可有效抑制小儿先心病手术后胸部正中切口的瘢痕增生。Objective To explore the efficacy of using medical adhesive and silicagel dressing for scar hyperplasia after chest median incision in children with congenital heart disease(CHD).Methods A total of 160 CHD cases underwent median sternotomy.They were randomly divided into 4 groups of A(medical adhesive treatment),B(silicone dressing treatment),C(sequential medical adhesive silicone dressing treatment)and D(control)(n=40 each).Formation of wound scar was evaluated after treatment for 1,6,3,12 months.The Vancouver Scar Scale was used for assessing scar color,vascular distribution,thickness and softness.Then statistical analysis was performed.Results The hypertrophic scar scores of A,B and C groups were lower than those of D group after 1 month.However the difference was not statistically significant(P >0.05);after 3,6 and 12 months,the hypertrophic scar scores of A,B and C groups were lower than those of D group.And the differences were statistically significant(P<0.05);the hypertrophic scar score of C group was lower than A and B groups.The difference was statistically significant(P<0.05).However,no significant differences existed between A and B groups.None of them had no obvious adverse reactions during treatment.Conclusion Medical adhesive sequential silicone dressing can significantly suppress the proliferation of scar tissue after middle thoracic incision in children with congenital heart disease.

关 键 词：瘢痕增生 医用粘合胶 心脏病/先天性 手术后期间 儿童 

分 类 号：R726.2[医药卫生—儿科] R725.4[医药卫生—临床医学]