小切口連續(xù)皮內(nèi)縫合法與常規(guī)切口單純縫合法在體表脂肪瘤切除中應(yīng)用效果對比

陳光新

【摘要】 目的：分析小切口連續(xù)皮內(nèi)縫合法與常規(guī)切口單純縫合法在體表脂肪瘤切除中應(yīng)用效果。方法：回顧性分析2018年5月-2019年5月本院門診手術(shù)的58例體表脂肪瘤患者臨床資料，根據(jù)術(shù)后縫合方式分為連續(xù)皮內(nèi)縫合組（n=30）和單純縫合組（n=28）。兩組患者均進(jìn)行體表脂肪瘤的切除術(shù)，單純縫合組患者手術(shù)采用常規(guī)切口，手術(shù)結(jié)束時采用單純縫合法進(jìn)行縫合;連續(xù)皮內(nèi)縫合患者手術(shù)采用小切口，手術(shù)結(jié)束時采用連續(xù)皮內(nèi)縫合法進(jìn)行縫合。比較兩組患者術(shù)后切口愈合情況、術(shù)后滿意度、并發(fā)癥的發(fā)生情況，術(shù)后1個月采用溫哥華瘢痕量表（VSS）、觀測者瘢痕評價量表（OSAS）對美觀度進(jìn)行評分。結(jié)果：連續(xù)皮內(nèi)縫合組患者甲級愈合率（90.00%）略高于單純縫合組（82.14%），比較差異無統(tǒng)計學(xué)意義（P>0.05）;連續(xù)皮內(nèi)縫合組術(shù)后滿意度高于單純縫合組（P<0.05）;連續(xù)皮內(nèi)縫合組術(shù)后并發(fā)癥發(fā)生率低于單純縫合組（P<0.05）;連續(xù)皮內(nèi)縫合組術(shù)后1個月連續(xù)縫合組患者VSS、OSAS評分均低于單純縫合組（P<0.05）。結(jié)論：與常規(guī)切口單純縫合法相比，小切口連續(xù)皮內(nèi)縫合法在體表脂肪瘤切除中應(yīng)用效果顯著，能夠促進(jìn)傷口的愈合、提高手術(shù)滿意度及減少術(shù)后并發(fā)癥的發(fā)生，且能減少瘢痕的增生從而增加美容效果。

【關(guān)鍵詞】 連續(xù)皮內(nèi)縫合 單純縫合 脂肪瘤 應(yīng)用效果

doi：10.14033/j.cnki.cfmr.2020.16.049 文獻(xiàn)標(biāo)識碼 B 文章編號 1674-6805（2020）16-0-03

Comparative of the Effect of Small Incision Continuous Intradermal Suture and Conventional Incision Simple Suture in the Treatment of Lipoma on the Body Surface/CHEN Guangxin. //Chinese and Foreign Medical Research， 2020， 18（16）： -123

[Abstract] Objective： To analyze the effect of small incision continuous intradermal suture and conventional incision simple suture in the resection of lipoma. Method： The clinical data of 58 patients with lipoma on the body surface from May 2018 to May 2019 were analyzed retrospectively. According to the postoperative sutures， they were divided into continuous intradermal sutures group （n=30） and simple sutures group （n=28）. The patients in the simple sutures group were sutured with conventional incision and simple suture at the end of the operation. The patients in the continuous intradermal sutures group were sutured with small incision and continuous intradermal suture at the end of the operation. One month after the operation， the Vancouver scar scale （VSS） and observer scar rating scale （OSAS） were used to evaluate the beauty. Result： The first-class healing rate in the continuous intradermal sutures group （90.00%） was slightly higher than that in the simple sutures group （82.14%）， but there was no significant difference （P>0.05）. The postoperative satisfaction rate in the continuous intradermal sutures group was higher than that in the simple sutures group （P<0.05）. The postoperative complications rate in the continuous intradermal sutures group was lower than that in the simple sutures group （P<0.05）. The score of VSS and OSAS one month after operation in the continuous intradermal sutures group were lower than those in the simple sutures group （P<0.05）. Conclusion： Compared with the conventional incision and simple suture， the small incision and continuous intradermal suture has a significant effect in the removal of lipoma on the body surface， which can promote the wound healing， improve the satisfaction of operation， reduce the occurrence of postoperative complications， and reduce the hyperplasia of scars， so as to increase the aesthetic effect.

2.4 兩組患者術(shù)后1個月VSS、OSAS評分對比

連續(xù)縫合組患者術(shù)后1個月VSS、OSAS評分均低于單純縫合組，差異均有統(tǒng)計學(xué)意義（P<0.05），見表4。

3 討論

體表脂肪瘤是外科當(dāng)中常見病、多發(fā)病，屬于起源于脂肪組織的良性腫瘤，由成熟的脂肪細(xì)胞所組成。患者以女性多見，多發(fā)年齡為30～50歲，腫瘤可單發(fā)或者多發(fā)，常發(fā)部位為頸部、肩部、臀部及背部等皮下組織，多呈分葉狀，質(zhì)地較為柔軟，無紅腫及壓痛，具有一定程度的活動度[7-8]。目前關(guān)于體表脂肪瘤的具體的發(fā)病機制尚未十分明確，有認(rèn)為與血脂的異常代謝具有相關(guān)性。