家长依从性对烧伤患儿增生性瘢痕治疗效果的影响

宋均辉; 夏正国; 周贤良; 李兴照; 胡正帅; 李鹏涛; 徐庆连

doi:10.3760/cma.j.cn501120-20210127-00038

家长依从性对烧伤患儿增生性瘢痕治疗效果的影响

doi: 10.3760/cma.j.cn501120-20210127-00038

1. 安徽医科大学第一附属医院烧伤科,合肥 230022;
2. 安徽医科大学第四附属医院创面修复与整形美容外科,合肥 230001

基金项目:

安徽省科技攻关计划（1604a0802083）

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出版历程
- 收稿日期: 2021-01-27
- 网络出版日期: 2021-10-28
- 刊出日期: 2021-05-20

Influence of parental compliance on the treatment of hypertrophic scars in burn children

1. Department of Burns, the First Affiliated Hospital of Anhui Medical University, Hefei 230022, China;
2. Department of Wound Repair, Plastic and Aesthetic Surgery, the Fourth Affiliated Hospital of Anhui Medical University, Hefei 230001, China

摘要

摘要:
目的探讨家长依从性对烧伤患儿增生性瘢痕治疗效果的影响。方法采用回顾性队列研究方法。2014年6月—2019年6月，于安徽医科大学第一附属医院烧伤科门诊就诊的49例烧伤后增生性瘢痕患儿符合入选标准，纳入本研究。随访9个月时，根据挂号单及针对家长的依从性问卷调查结果，将患儿分为依从性佳组［34例，男21例、女13例，年龄2.0（2.0，3.5）岁］和依从性差组［15例，男6例、女9例，年龄3.0（2.0，4.0）岁］。首次就诊时和随访3、6、9个月，采用温哥华瘢痕量表（VSS）对依从性佳组患儿行瘢痕评分；首次就诊时和随访9个月，采用VSS对依从性差组患儿行瘢痕评分；首次就诊时和随访9个月，采用语言分级评分法（VRS）对2组患儿行瘢痕瘙痒评分。对数据行
χ
²检验、Wilcoxon秩和检验、Mann-Whitney
U
检验、独立样本
t
检验、配对样本
t
检验。结果首次就诊时，2组患儿瘢痕VSS色泽、血管分布、柔软度、厚度评分及总评分均相近（
Z
=0.834、0.026、0.837、0.076、1.074，
P>
0.05）；随访9个月，依从性佳组患儿瘢痕VSS柔软度、厚度评分及总评分均明显低于依从性差组（
Z
=5.518、4.732、5.042，
P<
0.01）。与首次就诊时相比，依从性佳组患儿随访9个月瘢痕VSS色泽、血管分布、柔软度、厚度评分及总评分均明显降低（
Z
=5.241、5.273、5.214、5.245、3.451，
P<
0.01）；依从性差组患儿随访9个月瘢痕VSS色泽、血管分布评分及总评分均明显降低（
Z
=3.606、3.542、3.448，
P<
0.01）。首次就诊时，依从性佳组患儿瘢痕瘙痒VRS评分为6.00（5.00，6.25）分，与依从性差组的（5.47±1.69）分相近（
Z=
0.607，
P>
0.05）；随访9个月，依从性佳组患儿瘢痕瘙痒VRS评分为1.00（1.00，1.25）分，明显低于依从性差组的（3.27±1.71）分（
Z
=2.606，
P<
0.01）。与首次就诊时相比，依从性佳组患儿随访9个月瘢痕瘙痒VRS评分明显降低（
Z
=4.002，
P<
0.01），依从性差组患儿随访9个月瘢痕瘙痒VRS评分无明显变化（
t
=3.550，
P>
0.05）。结论在治疗方案相同的情况下，家长良好的依从性对烧伤患儿增生性瘢痕治疗有积极影响，可降低瘢痕增生和瘙痒程度。
- 烧伤 /
- 瘢痕 /
- 儿童 /
- 家长依从性
Abstract:
Objective To explore the influence of parental compliance on the treatment of hypertrophic scars in burn children. Methods A retrospective cohort study method was used. From June 2014 to June 2019, 49 children with post-burn hypertrophic scars who met the inclusion criteria and visited the outpatient department of the Department of Burns of the First Affiliated Hospital of Anhui Medical University were included in this study. In the follow-up of 9 months, according to the registration form and the results of the compliance questionnaire for parents, the children were divided into good compliance group (34 cases, 21 males and 13 females, aged 2.0 (2.0, 3.5) years) and poor compliance group (15 cases, 6 males and 9 females, aged 3.0 (2.0, 4.0) years). At the first attendance and in the follow-up of 3, 6, and 9 months, the scar scores of children in good compliance group were evaluated by Vancouver Scar Scale (VSS). At the first attendance and in the follow-up of 9 months, the scar scores of children in poor compliance group were evaluated by VSS. At the first attendance and in the follow-up of 9 months, the scar pruritus scores of children in the 2 groups were evaluated by Verbal Rating Score (VRS). Data was statistically analyzed with chi-square test, Wilcoxon rank sum test, Mann-Whitney
U
test, independent sample
t
test, and paired sample
t
test. Results At the first attendance, the color, vascular distribution, softness, and thickness scores, and total score in VSS scoring of scars of children in the two groups were similar (
Z
=0.834, 0.026, 0.837, 0.076, 1.074,
P
>0.05). In the follow-up of 9 months, the softness and thickness scores, and total score in VSS scoring of scars of children in good compliance group were significantly lower than those in poor compliance group (
Z
=5.518, 4.732, 5.042,
P
<0.01). Compared with those in the first attendance, the color, vascular distribution, softness, and thickness scores, and total score in VSS scoring of scars of children in good compliance group were significantly decreased in the follow-up of 9 months (
Z
=5.241, 5.273, 5.214, 5.245, 3.451,
P
<0.01); the color and vascular distribution scores, and total score in VSS scoring of scars of children in poor compliance group were significantly decreased in the follow-up of 9 months (
Z
=3.606, 3.542, 3.448,
P
<0.01). At the first attendance, the VRS score of scar pruritus of children in good compliance group was 6.00 (5.00, 6.25) points, which was similar to (5.47±1.69) points in poor compliance group (
Z
=0.607,
P
>0.05). In the follow-up of 9 months, the VRS score of scar pruritus of children in good compliance group was 1.00 (1.00, 1.25) points, which was significantly lower than (3.27±1.71) points in poor compliance group (
Z
=2.606,
P
<0.01). Compared with those in the first attendance, the VRS score of scar pruritus of children in good compliance group was significantly decreased in the follow-up of 9 months (
Z
=4.002,
P
<0.01), while there was no obvious change in poor compliance group in the follow-up of 9 months (
t
=3.550,
P
>0.05). Conclusions Under the same treatment plan, good parental compliance has a positive effect on the treatment of hypertrophic scars in burn children decreasing the degree of scar hyperplasia and pruritus.
- Burns /
- Cicatrix /
- Child /
- Parental compliance