整形外科手术方法在手部深度烧伤后瘢痕预防及功能恢复中的应用  

Application of Plastic Surgery in Prevention of Scar and Recovery of Functional after Deep Burn of Hand

作　　者：韩亚龙[1] 刘文军[1] 李武全[1] 刘军[1] 张嘉[1] 魏迪南[1] HAN Ya-long;LIU Wen-jun;LI Wu-quan;LIU Jun;ZHANG Jia;WEI Di-nan(Department of Burn,Second Affiliated Hospital of Kunming Medical University,Kunming 650101,Yunnan,China)

机构地区：[1]昆明医科大学第二附属医院烧伤科

出　　处：《中国美容医学》2019年第11期3-6,共4页Chinese Journal of Aesthetic Medicine

摘　　要：目的:观察整形外科手术方法在手部深度烧伤后瘢痕预防及功能恢复中的应用效果。方法:选取笔者医院(2017年-2018年)收治的84例手部深度烧伤患者,依据入院顺序单双号分为两组,各42例。两组均接受常规治疗,对照组在其基础上给予肉芽组织清创联合植小皮片治疗;观察组于常规治疗基础上应用整形外科手术方法。比较两组治疗后温哥华瘢痕量表(Vancouver scar scale,VSS)评分、密歇根手功能量表(Michigan hand outcomes questionnaire,MHQ)评分、日常生活活动能力(Activity of daily living scale,ADL)恢复情况,并以手指关节总活动度(Total active movement,TAM)评估两组组疗效。结果:观察组手指关节活度恢复优良率92.86%,明显高于对照组的73.81%,差异有统计学意义(P<0.05)。治疗3个月后,观察组色泽、柔软度、血管分布以及厚度评分显著低于对照组,差异有统计学意义(P<0.05)。观察组手部总体功能、工作能力、日常生活能力、外观以及对手的满意度评分明显高于对照组,差异有统计学意义(P<0.05);疼痛评分明显低于对照组,差异有统计学意义(P<0.05)。ADL量表中,两组穿鞋评分比较差异无统计学意义(P>0.05);观察组进食、洗脸、刷牙、梳头、穿衣及剪指甲评分明显高于对照组(P<0.05)。结论:对手部深度烧伤患者采取整形外科手术方法,能有效改善瘢痕形成情况,促进手功能与日常生活能力的恢复。Objective To observe the effect of plastic surgery on scar prevention and functional recovery after deep burn of hand.Methods Eighty-four cases of patients with deep hand burns admitted to our hospital(2017-2018)were divided into two groups according to admission order,42 cases in each group.The two groups were given routine treatment,while the control group were treated with granulation tissue debridement combined with skin grafting,the observation group were treated with plastic surgery on the basis of routine treatment,the Vancouver Scar scale(VSS),Michigan Hand Outcomes Questionnaire(MHQ),Activity of Daily Living Scale(ADL)after treatment between the two groups were compared.The two groups were evaluated by Total Active Movement(TAM).Results The excellent and good rate of finger joint activity recovery of the observation group was 92.86%,which was significantly higher than the control group(73.81%),the difference was statistically significant(P<0.05).The scores of scar color,softness,vascular distribution and thickness after 3 months of treatment of the observation group were significantly lower than the control group(P<0.05).The scores of hand function,work ability,daily living ability,appearance and satisfaction of the observation group were significantly higher than the control group(P<0.05).The pain score of the observation group was significantly lower than the control group(P<0.05).In the ADL scale,the difference of scores of wearing shoes between the two groups was not significant(P>0.05).The scores of eating,washing face,brushing teeth,combing hair,dressing and cutting nails of the observation group were significantly higher than the control group(P<0.05).Conclusion Plastic surgery can effectively improve scar formation and promote the recovery of hand function and daily living ability of patients with deep burn of hand.

关 键 词：深度烧伤 手部 整形外科治疗 手术治疗 瘢痕形成 功能恢复 

分 类 号：R622[医药卫生—整形外科]