摘要
目的研究扩张后胸三角皮瓣带蒂转移修复术与扩张后随意型皮瓣修复术治疗面颈部烧伤后瘢痕患者临床疗效及对颈部功能、瘢痕恢复状况的影响。方法以2020年07月—2023年07月期间本院收集136例面颈部烧伤后瘢痕患者为研究对象,根据不同修复方法分胸三角皮瓣组(n=70)、任意型皮瓣组(n=66),前者行扩张后胸三角皮瓣带蒂转移修复术,后者行扩张后随意型皮瓣修复术。比较两组手术前后颈部功能、温哥华瘢痕量表(VSS)、生化指标[血小板衍生因子(PDGF)、转化生长因子-β1(TGF-β1)、血管内皮生长因子(VEGF)]水平、疼痛数字评价量表(NRS)评分、烧伤患者健康量表(BSHS-C)评分及并发症状况。结果术后3个月,胸三角皮瓣组颈部功能优于任意型皮瓣组(P<0.05);术后3个月,与任意型皮瓣组相比,胸三角皮瓣组VSS评分较低(P<0.05);术后1个月,与任意型皮瓣组相比,胸三角皮瓣组PDGF、TGF-β1、VEGF水平较高(P<0.05);术后3个月,与任意型皮瓣组相比,胸三角皮瓣组BSHS-C评分较高、NRS评分较低(P<0.05);胸三角皮瓣组并发症总发生率(0.00%)低于任意型皮瓣组(10.60%)(P<0.05)。结论扩张后胸三角皮瓣带蒂转移修复术能改善患者颈部功能,降低VSS、BSHS-C、NRS评分,改善生化指标,安全性好。
Objective To study the clinical efficacy of expanded thoracic triangle flap pedicled transfer repair and expanded arbitrary flap repair in the treatment of scar after facial and neck burn,and its influence on the function of neck and scar recovery.Methods A total of 136 patients with facial and neck burn scar from July 1,2020 to July 31,2023 were collected in our hospital.According to different repair methods,the patients were divided into three groups(n=70)and two groups(n=66).The former group received expanded triangular flap with pedicled transfer repair,and the latter group received expanded and arbitrary flap repair.Neck function,Vancouver Scar Scale(VSS),biochemical indices[platelet-derived factor(PDGF),transforming growth factor-β1(TGF-β1),vascular endothelial growth factor(VEGF)]levels,numerical Pain Rating Scale(NRS)score,burn Patient Health Scale(BSHS-C)score and complication status were compared between the two groups before and after surgery.Results At 3 months after operation,the function of the neck of thoracic triangular flap group was better than that of any flap group(P<0.05).At 3 months after operation,VSS score of thoracic triangular flap group was lower than that of any flap group(P<0.05).One month after operation,the levels of PDGF,TGF-β1 and VEGF were higher in thoracic triangular flap group than in any flap group(P<0.05).At 3 months after operation,the scores of BSHS-C and NRS were lower in thoracic triangular flap group than in any flap group(P<0.05).The total complication rate of thoracic triangular flap group(0.00%)was lower than that of any flap group(10.60%)(P<0.05).Conclusions Expansion of thoracic triangular flap with pedicled transfer repair can improve neck function,reduce VSS,BSHS-C,NRS scores,improve biochemical indexes,and have good safety.
作者
朱广乾
张君君
汪政超
ZHU Guangqian;ZHANG Junjun;WANG Zhengchao(Department of Plastic Surgery and Cosmetology,Xuchang Municipal Hospital,Xuchang 461000,Henan,China)
出处
《航空航天医学杂志》
2024年第4期385-388,共4页
Journal of Aerospace medicine
基金
河南省医学科技攻关联合共建项目LHGJ20221027。
关键词
面颈部烧伤
胸三角皮瓣
随意型皮瓣
颈部功能
瘢痕恢复状况
Facial and neck burn
Thoracic triangular flap
Random skin flap
Neck function
Scar recovery status
