手术后伤口皮肤张力变化与病理性瘢痕形成相关性的基础与临床研究  

Basic and Clinical Study on the Correlation between Skin Tension Changes and Pathologic Scar Formation in Post⁃operative Wounds

作　　者：卢晖 吴慧玲 张刚 韦伟 王旭东 Lu Hui;Wu Huiling;Zhang Gang;Wei Wei;Wang Xudong(Department of Plastic and Reconstructive Surgery,the First Dongguan Affiliated Hospital of Guangdong Medical University(the South-east General Hospital of Dongguan),Dongguan 523710,Guangdong Province,China;Health Management Center,the First Dongguan Affiliated Hospital of Guangdong Medical University(the Southeast General Hospital of Dongguan),Dongguan 523710,Guangdong Province,China)

机构地区：[1]广东医科大学附属东莞第一医院(东莞市东南部中心医院)整形外科,广东东莞523710 [2]广东医科大学附属东莞第一医院(东莞市东南部中心医院)健康管理中心2,广东东莞523710

出　　处：《中外医药研究》2024年第11期63-66,共4页JOURNAL OF CHINESE AND FOREIGN MEDICINE AND PHARMACY RESEARCH

基　　金：广东省医学科研基金项目(卫生厅)资助(编号:C2022127);东莞市社会发展科技项目(编号:20221800905672)。

摘　　要：目的:探究手术后伤口皮肤张力变化与病理性瘢痕形成的相关性。方法:选取2021年5—12月东莞市东南部中心医院收治的手腕或足踝处有较大开放性手术切口残留的患者180例作为研究对象。根据治疗后的伤口皮肤张力分为高张力组(33例)、正常张力组(117例)、低张力组(30例)。比较三组瘢痕宽度、温哥华瘢痕量表评分、细胞外基质成分、成纤维细胞分泌细胞因子水平,分析手术后伤口皮肤张力变化与瘢痕宽度的相关性。结果:术后90 d,三组瘢痕宽度大于术后30 d,差异有统计学意义(P<0.05);术后30、90 d,三组瘢痕宽度比较,差异有统计学意义(P<0.05)。术后90 d,三组温哥华瘢痕量表评分高于术后30 d,差异有统计学意义(P<0.05);术后30、90 d,三组温哥华瘢痕量表评分比较,差异有统计学意义(P<0.05)。术后90 d,三组瘢痕组织标本转化生长因子-β1、血小板源性生长因子、内皮缩血管肽、血管内皮细胞生长因子、碱性成纤维细胞生长因子水平比较,差异有统计学意义(P<0.05)。三组纤维连接蛋白、免疫球蛋白G、免疫球蛋白A、胶原纤维、网状纤维、中性黏多糖、酸性黏多糖成分比较,差异有统计学意义(P<0.05)。术后伤口皮肤张力与瘢痕宽度呈正相关(r=0.996,P=0.032)。结论:手术后伤口皮肤张力变化与瘢痕宽度相关,手术后伤口皮肤张力越大,越容易导致瘢痕增大。Objective:To investigate the correlation between skin tension changes and pathologic scar formation in postoperative wounds.Methods:One hundred and eighty patients admitted to the Southeast General Hospital of Dongguan with large open surgical incision remnants at the wrist or ankle from May to December 2021 were selected as study subjects.According to the wound skin tension after treatment,they were divided into high-tension group(thirty-three cases),normal-tension group(one hundred and sev⁃enteen cases),and low-tension group(thirty cases).The scar width,Vancouver Scar Scale score,extracellular matrix composition,and fibroblast secretion cytokine level were compared among the three groups,and the correlation between the change of wound skin tension and scar width after surgery was analyzed.Results:At 90 d after surgery,the scar width of the three groups was greater than that at 30 d after surgery,and the difference was statistically significant(P<0.05);at 30 and 90 d after surgery,the scar widths of the three groups were compared,and the differences were statistically significant(P<0.05).At 90 d after surgery,the scores of the Van⁃couver Scar Scale of the three groups were higher than that at 30 d after surgery,and the differences were statistically significant(P<0.05);at 30 and 90 d postoperatively,the Vancouver Scar Scale scores of the three groups were compared,and the difference was statistically significant(P<0.05).At 90 d postoperatively,the levels of transforming growth factor-β1,platelet-derived growth factor,endothelial vasoconstrictor peptide,vascular endothelial growth factor,and basic fibrobast growth factor in the three groups were compared in the specimens of scar tissue,and the difference was statistically significant(P<0.05).Comparison of fibronectin,immuno⁃globulin G,immunoglobulin A,collagen fibers,reticular fibers,neutral mucopolysaccharides,and acidic mucopolysaccharides com⁃positions among the three groups showed statistically significant differences(P<0.05).There was a positive cor

关 键 词：皮肤张力 病理性瘢痕 细胞外基质 成纤维细胞 

分 类 号：R622[医药卫生—整形外科]