儿童面部急性外伤临床分析及整形美容技术的应用探讨  

Clinical analysis of children’s acute facial trauma and application of plastic surgery technology

作　　者：岳晓洁[1] 戴叶锋[1] 赵雄[1] 姜润松 Yue Xiaojie;Dai Yefeng;Zhao Xiong;Jiang Runsong(Department of Burn and Plastic Surgery,the Children’s Hospital,Zhejiang University School of Medicine,National Clinical Research Center for Child Health,Hangzhou 310000,China)

机构地区：[1]浙江大学医学院附属儿童医院烧伤整形外科,国家儿童健康与疾病临床医学研究中心,杭州310000

出　　处：《中华整形外科杂志》2021年第10期1163-1167,共5页Chinese Journal of Plastic Surgery

摘　　要：目的了解儿童面部急性外伤的临床特点,探讨整形美容技术用于修复儿童面部急性外伤的临床效果。方法回顾性分析2017年6月至2018年6月浙江大学医学院附属儿童医院烧伤整形外科收治的面部急性外伤患儿的临床资料,所有患儿均接受整形美容治疗,并于术后3、6、12个月随访,采用瘢痕美容评估及评级量表(SCAR)评价瘢痕情况,调查患儿家长对瘢痕的满意度。分析患儿的面部急性外伤的临床特点。采用GraphPad Prism 8.0.0进行统计学分析,组间比较采用方差分析,组间两两比较采用LSD-t检验,采用多因素回归分析探索影响患儿家长对瘢痕满意度的主要因素,P<0.05表示差异有统计学意义。结果共纳入面部外伤患儿338例(364处),男223例,女115例,年龄1~14岁,平均4.5岁。其中磕伤307例,锐器割伤14例,车祸伤13例,狗咬伤3例,高处坠落伤1例,累及多个解剖区域,其中额部(174例)最多,所有创面均采用整形美容技术成功修复。术后3、6、12个月瘢痕SCAR评分分别为(2.9±1.0)分、(1.9±0.7)分、(1.8±0.8)分,3组间比较差异有统计学意义(P<0.01);术后3个月分别与术后6、12个月比较,差异均有统计学意义(P<0.01);术后6个月与术后12个月比较,差异无统计学意义(P>0.05)。术后3、6、12个月家长满意度评分分别为(7.4±0.7)分、(7.9±0.7)分、(8.2±0.8)分,3组间比较差异有统计学意义(P<0.01);术后12个月分别与术后3、6个月比较,差异均有统计学意义(P<0.01);术后3个月与术后6个月比较,差异无统计学意义(P>0.05)。多因素回归分析显示,创口受累区域是否多发及预后瘢痕的宽度是影响患儿家长对瘢痕满意度的主要因素。结论儿童面部急性外伤多由钝物磕伤引起,额部好发。根据创面特点采用整形美容技术修复儿童面部急性外伤,可以实现伤口最佳愈合,改善瘢痕预后,有望进一步提高患者满意度。Objective To investigate the clinical features of children’s acute facial trauma,and to explore the clinical effects of plastic surgery in the repair of children’s acute facial trauma.Methods The clinical data of children with acute facial trauma who were admitted to Children’s Hospital Affiliated to Zhejiang University School of Medicine from June 2017 to June 2018 were retrospectively analyzed.All children received plastic surgery treatment,and were followed up at 3,6 and 12 months after operation.Scar cosmesis assessment and rating(SCAR)was used to evaluate the scar condition,and the parents’satisfaction with scar was investigated.The clinical characteristics of acute facial trauma in children were analyzed.Graphpad prism 8.0.0 was used for statistical analysis,one-way ANOVA was used for comparison between groups,LSD-t test was used for pairwise comparison between groups,multivariate regression analysis was used to explore the main factors affecting parents’satisfaction with scar.P<0.05 showed that the difference was statistically significant.Results A total of 338 children(364 wounds)with acute facial trauma were included,consisting of 223 males and 115 females,aged from 1 to 14 years,with an average of 4.5 years.All wounds were successfully repaired by plastic surgery.The SCAR scores at 3 months,6 months and 12 months after operation were 2.9±1.0,1.9±0.7 and 1.8±0.8 respectively,showing significant difference among there groups(P<0.01).The SCAR score at 3 months after operation was significantly different from that at 6 and 12 months after operation(P<0.01).There was no significant difference in SCAR score between 6 months and 12 months after operation(P>0.05).The parents’satisfaction scores at 3,6 and 12 months after operation were 7.4±0.7,7.9±0.7 and 8.2±0.8 respectively,showing significant difference among there groups(P<0.01).The parents’satisfaction score at 12 months after operation was significantly different from that at 3 and 6 months after operation(P<0.01).There was no signific

关 键 词：儿童 面部急性外伤 整形美容技术 瘢痕 满意度 

分 类 号：R726.2[医药卫生—儿科]