甲状腺术中注射倍他米松超前预防颈部切口瘢痕形成的研究  

Preemptive prevention of cervical incision scar formation by betamethasone injection during thyroid surgery

作　　者：李国庆 孙文聪 丁超 王熠辰 张恒 陈丹丹 苏自杰 Li Guoqing;Sun Wencong;Ding Chao;Wang Yichen;Zhang Heng;Chen Dandan;Su Zijie(Department of Thyroid Surgery,Henan Provincial People’s Hospital,Zhengzhou University People’s Hospital,Zhengzhou 450003,China;Department of Anesthesia and Perioperative Medicine,Henan Provincial People’s Hospital,Zhengzhou University People’s Hospital,Zhengzhou 450003,China)

机构地区：[1]河南省人民医院郑州大学人民医院甲状腺外科,郑州450003 [2]河南省人民医院郑州大学人民医院麻醉与围术期医学科,郑州450003

出　　处：《中华实验外科杂志》2023年第6期1106-1108,共3页Chinese Journal of Experimental Surgery

摘　　要：目的:探讨甲状腺开放手术中真皮下小剂量连续注射倍他米松可以超前预防颈部切口瘢痕的形成。方法:200例甲状腺肿瘤患者均行甲状腺开放切除术,本研究采用自身对照的方法。在甲状腺手术结束前,关闭颈部切口时,以切口中点为分界线,平分为左右两段,左侧为注射区,右侧为对照区。注射区切口上下切缘真皮层小剂量连续注射倍他米松,对照区切口不进行任何注射。持续观察切口瘢痕形成情况,术后随访至1年。采用温哥华瘢痕量表(VSS)、曼彻斯特瘢痕评定量表(MSS)及斯托尼布鲁克瘢痕评估量表(SBSES)分别对注射区及对照区打分。两组比较采用独立样本t检验。结果:术后6个月注射区VSS、MSS、SBSES评分优于对照区[(6.20±3.67)分比(7.14±4.52)分,t=-2.324,P<0.05、(7.46±4.48)分比(9.20±5.08)分,t=-3.638,P<0.05、(2.84±1.42)分比(2.35±1.44)分,t=-3.432,P<0.05];12个月注射区VSS、MSS、SBSES评分优于对照区评分[(6.24±3.92)分比(6.51±4.11)分,t=-0.691,P<0.05、(7.46±4.38)分比(8.85±4.88)分,t=-2.992,P<0.05、(2.54±1.49)分比(2.08±1.46)分,t=3.112,P<0.05]。结论:甲状腺术中注射倍他米松可以超前预防颈部切口瘢痕的形成。Objective To investigate the effect of continuous low dose betamethasone injection under the dermis on preemptive prevention of cervical incision scar formation in thyroid surgery.Methods Totally,200 patients with thyroid tumors who underwent open thyroidectomy were enrolled in this study.Before the end of thyroid surgery,when the neck incision was closed,the midpoint of the incision was used as the dividing line,and the neck incision was divided into two segments:the left side was the injection area,and the right side was the control area.A small dose of betamethasone was continuously injected into the dermis of the upper and lower margins of the incision in the injection area,and no injection was performed on the incision in the control area.The incision scar formation was continuously observed and followed up for 1 year after operation.The vancouver scar scale(VSS),manchester scar scale(MSS)and stony brook scar evaluation scale(SBSES)were used to evaluate the scar formation,score the injection area and the control area,respectively.Results At 6th month after surgery,the scores of VSS,MSS and SBSES in the injection area were higher than those in the control area[(6.20±3.67)vs.(7.14±4.52)](t=-2.324,P<0.05),[(7.46±4.48)vs.(9.20±5.08)](t=-3.638,P<0.05),[(2.84±1.42)vs.(2.35±1.44)](t=-3.432,P<0.05).The scores of VSS,MSS and SBSES in the 12-month injection area were higher than those in the control area[(6.24±3.92)vs.(6.51±4.11)](t=-0.691,P<0.05),[(7.46±4.38)vs.(8.85±4.88)](t=-2.992,P<0.05),[(2.54±1.49)vs.(2.08±1.46)](t=3.112,P<0.05).The differences were all statistically significant.Conclusion Betamethasone injection during thyroid surgery can prevent the formation of cervical incision scar in advance.

关 键 词：瘢痕增生 颈部切口 甲状腺肿瘤 术中注射 

分 类 号：R736.1[医药卫生—肿瘤]