壳聚糖季铵盐硅凝胶预防术后切口增生性瘢痕效果观察(1)
[摘要]目的：探究殼聚糖季铵盐硅凝胶预防术后切口增生性瘢痕形成的效果。方法：将2017年1月-2019年6月笔者医院妇产科收治的行手术治疗的120例患者，随机分为观察组(60例)和对照组(60例)。观察组采用壳聚糖季铵盐硅凝胶治疗，对照组采用曲安奈德局部注射治疗。比较两组温哥华瘢痕量表(Vancouver scar scale，VSS)评分、疼痛视觉模拟评分(Visual analogue scale，VAS)、症状减轻时间、瘢痕美观度及不良反应情况。结果：干预后两组瘢痕色泽、厚度、柔软度和血管分布评分较干预前均显著降低，且观察组低于对照组，差异有统计学意义(P<0.05)。两组术后20d、30d、40d的VAS评分均较术后10d显著降低，且观察组均显著低于对照组，差异有统计学意义(P<0.05)。观察组的充血消失用时、痒感消失用时、疼痛减轻用时和厚度减小用时均显著短于对照组，差异有统计学意义(P<0.05)。干预后，两组瘢痕硬度、患者和观测者瘢痕评价量表(POSAS)评分均较治疗前降低，且观察组低于对照组，差异有统计学意义(P<0.05)。观察组不良反应发生率为3.33%，显著低于对照组的16.67%，差异有统计学意义(P<0.05)。结论：壳聚糖季铵盐硅凝胶预防术后手术切口增生性瘢痕形成的疗效比曲安奈德更好，能有效降低瘢痕厚度、减轻患者疼痛，且不良反应轻微，值得推广。
[关键词]壳聚糖季铵盐硅凝胶;曲安奈德;增生性瘢痕;疗效;疼痛度
[中图分类号]R619+.6 [文献标志码]A [文章编号]1008-6455(2020)08-0093-04
Effect of Chitosan Quaternary Ammonium Salt Silica Gel on Prevention of Postoperative Hypertrophic Scar Formation
ZHU Li1，ZHU Shuang-yue2，TAN Xiao-hong3，XIE Qing-qin1，HU Xiao-ya3
(1.The Outpatient Department，Chongqing Kaizhou District People's Hospital，Chongqing 405400，China;2.Department of Nursing，Wutong Township Health Center，Kaizhou District，Chongqing 405400，China;3.Department of Nursing，Chongqing Kaizhou District People's Hospital，Chongqing 405400，China)
Abstract： Objective To investigate the effect of chitosan quaternary ammonium salt silicone gel on preventing postoperative hypertrophic scar formation in surgical incision. Methods 120 patients admitted to our hospital for obstetrics and gynecology from January 2017 to June 2019 were randomly divided into the observation group (60 cases) and the control group (60 cases). The observation group was treated with chitosan quaternary ammonium salt silica gel， and the control group was treated with local injection of triamcinolone acetonide. Two groups of Vancouver scar scale (VSS) scores， Visual analogue scale (VAS)， time to symptom relief， scar aesthetics， and adverse events were compared. Results After the intervention， the scar color， thickness， softness and vascular distribution scores of the two groups were significantly lower than those before the intervention， and the observation group was lower than the control group， the differences were statistically significant (P<0.05). The VAS scores of the two groups were significantly lower than those of the control group at 20， 30 and 40 days after operation， and the observation group was significantly lower than the control group (P<0.05). The time of congestion disappearance， itching disappearance， pain relief and thickness reduction in the observation group were significantly shorter than those in the control group (P<0.05). After the intervention， scar hardness， POSAS scores of patients and observers in the two groups were lower than those before treatment， and the observation group was lower than the control group (P<0.05). The incidence of adverse reactions in the observation group was 3.33%， significantly lower than that in the control group(16.67%， P<0.05). Conclusion Chitosan quaternary ammonium salt silica gel is better than triamcinolone acetonide in preventing postoperative surgical hypertrophic scar formation. It can effectively reduce the thickness of scar and reduce the pain of patients， and the adverse reactions are mild and worth promoting., 百拇医药(朱黎 朱爽悦 谭小红 谢青亲 胡小亚)
[关键词]壳聚糖季铵盐硅凝胶;曲安奈德;增生性瘢痕;疗效;疼痛度
[中图分类号]R619+.6 [文献标志码]A [文章编号]1008-6455(2020)08-0093-04
Effect of Chitosan Quaternary Ammonium Salt Silica Gel on Prevention of Postoperative Hypertrophic Scar Formation
ZHU Li1，ZHU Shuang-yue2，TAN Xiao-hong3，XIE Qing-qin1，HU Xiao-ya3
(1.The Outpatient Department，Chongqing Kaizhou District People's Hospital，Chongqing 405400，China;2.Department of Nursing，Wutong Township Health Center，Kaizhou District，Chongqing 405400，China;3.Department of Nursing，Chongqing Kaizhou District People's Hospital，Chongqing 405400，China)
Abstract： Objective To investigate the effect of chitosan quaternary ammonium salt silicone gel on preventing postoperative hypertrophic scar formation in surgical incision. Methods 120 patients admitted to our hospital for obstetrics and gynecology from January 2017 to June 2019 were randomly divided into the observation group (60 cases) and the control group (60 cases). The observation group was treated with chitosan quaternary ammonium salt silica gel， and the control group was treated with local injection of triamcinolone acetonide. Two groups of Vancouver scar scale (VSS) scores， Visual analogue scale (VAS)， time to symptom relief， scar aesthetics， and adverse events were compared. Results After the intervention， the scar color， thickness， softness and vascular distribution scores of the two groups were significantly lower than those before the intervention， and the observation group was lower than the control group， the differences were statistically significant (P<0.05). The VAS scores of the two groups were significantly lower than those of the control group at 20， 30 and 40 days after operation， and the observation group was significantly lower than the control group (P<0.05). The time of congestion disappearance， itching disappearance， pain relief and thickness reduction in the observation group were significantly shorter than those in the control group (P<0.05). After the intervention， scar hardness， POSAS scores of patients and observers in the two groups were lower than those before treatment， and the observation group was lower than the control group (P<0.05). The incidence of adverse reactions in the observation group was 3.33%， significantly lower than that in the control group(16.67%， P<0.05). Conclusion Chitosan quaternary ammonium salt silica gel is better than triamcinolone acetonide in preventing postoperative surgical hypertrophic scar formation. It can effectively reduce the thickness of scar and reduce the pain of patients， and the adverse reactions are mild and worth promoting., 百拇医药(朱黎 朱爽悦 谭小红 谢青亲 胡小亚)