低功率电刀切皮联合术后皮下整形减张缝合减轻开放性甲状腺手术颈部瘢痕的临床效果  

Clinical effect of low-power electrocautery skin incision combined with subcutaneous plastic tension-reducing suture in alleviating neck scars from open thyroid surgery

作　　者：曹云凯 刘紫琪 欧克儒 谭月梅 何阳阳[1] 洪勇[1] CAO Yunkai;LIU Ziqi;OU Keru;TAN Yuemei;HE Yangyang;HONG Yong(Department of Thyroid and Breast Surgery,Nanxishan Hospital of Guangxi Zhuang Autonomous Region,Guilin 541002,China;不详)

机构地区：[1]广西壮族自治区南溪山医院甲状腺乳腺外科,广西桂林541002 [2]桂林医学院研究生院(处),广西桂林541010

出　　处：《山东医药》2025年第2期51-55,共5页Shandong Medical Journal

基　　金：广西壮族自治区临床重点专科建设(培育)项目[桂卫医发(2022)17号];广西医疗卫生适宜技术开发与推广应用项目(S2020067);广西壮族自治区桂林市临床重点专科建设项目[市卫医(2019)36号]。

摘　　要：目的探讨低功率电刀切皮联合术后皮下整形减张缝合减轻开放性甲状腺手术颈部瘢痕的临床效果。方法选择接受开放性甲状腺手术患者383例,根据手术器械和缝合方式不同,分为A、B、C三组。其中,A组126例,予传统手术刀切皮+术后传统皮下间断缝合;B组132例,予低功率电刀切皮+术后传统皮下间断缝合;C组125例,予低功率电刀切皮+术后皮下整形减张缝合。比较三组围手术期相关指标[手术时间、术中出血量、术后引流量、住院时间以及术后12、36 h疼痛视觉模拟评分(VAS)]、切口并发症情况(切口感染、皮下积液或血肿、切口脂肪液化等);术后1、6、12个月,采用温哥华瘢痕评定量表(VSS)及患者瘢痕评估量表(PSAS)评分评估颈部瘢痕程度。结果三组手术时间、术中出血量、术后引流量及术后12、36 h VAS评分和住院时间比较差异均无统计学意义(P均>0.05)。三组切口感染、皮下血肿、脂肪液化等术后切口并发症的发生率比较差异无统计学意义(P>0.05)。三组术后1、6、12个月VSS评分和PSAS评分均逐渐降低(P均<0.05);C组术后1、6、12个月VSS评分和PSAS评分均低于A、B组同期(P均<0.05)。结论低功率电刀切皮联合术后皮下整形减张缝合能够减轻开放性甲状腺手术颈部瘢痕,方法简单易行,安全性高。Objective To investigate the clinical efficacy of low-power electrocautery skin incision combined with subcutaneous plastic tension-reducing suture in reducing neck scars in open thyroid surgery.Methods A total of 383 pa tients who underwent open thyroid surgery were selected.According to different surgical instruments and suture methods,they were divided into three groups:groups A,B,and C.Group A consisted of 126 cases,and traditional surgical blades were used for skin incision followed by traditional subcutaneous interrupted sutures.Group B had 132 cases,and low-pow er electrocautery was used for skin incision followed by traditional subcutaneous interrupted sutures.Group C included 125 cases,and low-power electrocautery was used for skin incision followed by postoperative subcutaneous plastic tension-re ducing sutures.We compared the perioperative indicators[operation time,intraoperative blood loss,postoperative drain age volume,hospital stay,and pain visual analog scale(VAS)scores at 12 and 36 hours after operation],and incision complication status(incision infection,subcutaneous fluid collection or hematoma,incision fat liquefaction,etc.).At 1,6,and 12 months after operation,the Vancouver Scar Scale(VSS)and Patient Scar Assessment Scale(PSAS)were used to evaluate the degree of neck scars.Results There were no statistically significant differences in the operative time,in traoperative blood loss,postoperative drainage volume,VAS scores at 12 and 36 h after operation,or hospital stay dura tion(all P>0.05).The incidence rates of postoperative incision complications such as incision infection,subcutaneous he matoma,and fat liquefaction were not statistically different among the three groups(all P>0.05).The VSS and PSAS scores at 1,6,and 12 months after operation gradually decreased in all three groups(all P<0.05);the VSS and PSAS scores at 1,6,and 12 months after operation in the group C were lower than those in the groups A and B at the same time points(all P<0.05).Conclusion Low-power electrocautery skin incis

关 键 词：甲状腺手术 颈部瘢痕 低功率电刀 皮下整形减张缝合 

分 类 号：R653[医药卫生—外科学]