【摘要】 目的 探讨负压封闭引流术（VSD）在胸部烧伤后增生性瘢痕整形术中的应用价值。方法 选取2020年1月至2021年12月粤北人民医院收治的82例胸部增生性瘢痕患者，采用随机数字表法分为观察组（n=41）与对照组（n=41）。对照组行胸部瘢痕切除缝合术治疗，观察组行胸部瘢痕切除缝合联合VSD治疗。比较两组术前、术后瘢痕整体状态及瘢痕瘙痒、疼痛情况。结果 两组患者术后1、3、6、12个月时的温哥华瘢痕评定量表（VSS）总分和皮肤柔软度、色泽、厚度、血管分布评分均低于术前，术后3、6、12个月时的VSS总分和皮肤柔软度、色泽、厚度评分低于术后1个月，术后6、12个月时的VSS总分和皮肤柔软度、色泽、厚度、血管分布评分均低于术后3个月，而术后12个月时VSS总分和皮肤色泽、厚度、血管分布评分低于术后6个月，差异有统计学意义（P<0.05）；两组患者术后1、3、6、12个月时的瘢痕疼痛、瘙痒评分均低于术前，且术后3、6、12个月时的瘢痕疼痛、瘙痒评分低于术后1个月；术后6、12个月时的瘢痕疼痛、瘙痒评分均低于术后3个月；术后12个月时瘢痕疼痛、瘙痒评分低于术后6个月，差异有统计学意义（P<0.05）。结论 胸部烧伤后增生性瘢痕整形术中使用VSD治疗可更好地改善患者瘢痕整体状态，减轻患者瘢痕疼痛与瘙痒。更多还原

【Abstract】 Objective To explore the application value of vacuum sealing drainage(VSD) in the plastic surgery of hypertrophic scars after chest burns. Methods A total of 82 patients with chest hypertrophic scar admitted to Guangdong People’s Hospital from January 2020 to December 2021 were selected and they were divided into observation group(n=41) and control group(n=41) by random number table method. The control group was treated with chest scar excision and suture, and the observation group was treated with chest scar excision and suture combined with VSD. The overall status of scar, itching and pain before and after operation were compared between the two groups. Results The total score of vancouver scar scale(VSS) and skin softness, color, thickness and vascular distribution scores at 1, 3, 6 and 12 months after surgery were lower than those before surgery, and the total score of VSS and skin softness, color and thickness at 3, 6 and 12 months after surgery were lower than those at 1 month after surgery. The total VSS score and skin softness, color, thickness and blood vessel distribution scores at 6 and 12 months after surgery were lower than those of at 3 months after surgery, while the total VSS score and skin color, thickness and blood vessel distribution scores at 12 months after surgery were lower than those at6 months after surgery, with statistical significances(P<0.05). Scar pain and itch scores at 1, 3, 6 and 12 months after surgery were lower than those before surgery, and scar pain and itch scores at 3, 6 and 12 months after surgery were lower than those at 1 month after surgery. Scar pain and itch scores at 6 and 12 months after surgery were lower than those at 3months after surgery. Scar pain and itch scores at 12 months after surgery were lower than those at 6 months after surgery,and the differences were statistically significant(P<0.05). Conclusion The use of VSD in the plastic surgery of hypertrophic scar after chest burn can better improve the overall status of the scar and reduce the pain and itching of the scar.更多还原