反Z法与横切纵缝法内眦赘皮矫正术后瘢痕的比较分析-外科学(整形外科)专业论文.docx

摘 要 目的： 通过术后瘢痕美观度这一参照物，来评价反 Z 法与横切纵缝法两种术式在 矫正同等程度内眦赘皮的优劣性。 方法： 选取 2012 年 2 月至 2013 年 7 月期间于我院行内眦赘皮矫正术的患者 202 例（404 只眼），按内眦赘皮严重程度分为 A 组（轻度）、B 组（中度）和 C 组 （重度）。A 组患者中经随机选择采用反 Z 法的为 a1 组，采用横切纵缝法的为 a2 组。同理，B 组分为 b1 和 b2 组；C 组分为 c1 和 c2 组。术后 3 个月采用患者和观 察者瘢痕评价量表（POSAS）对内眦部瘢痕进行评价；同时拍摄数码相片并由研 究外人员进行独立评价。 结果： 共有 198 例（396 只眼）患者完成了随访。 A、B 和 C 组中含的各小组间患 者的一般临床特征差异均无统计学意义（P0.05）。术后 3 个月的对比结果为： A 组患者的瘢痕总体满意度评分分别为 a1（2.10±0.20）分和 a2（2.20±0.32）分， 2 组间比较差异无统计学意义（P=0.241）；b1 组（2.44±0.47）的瘢痕总体满意 度评分优于 b2 组（4.55±0.55），2 组间比较差异有统计学意义（P=0.010）；c1 组（4.70±0.71）患者的瘢痕总体满意度优于 c2 组（6.00±0.53），2 组间比较差 异有统计学意义（P=0.041）。其他的瘢痕评价量表（包括 PSAS 评分和 OSAS 评 分）与研究外人员对瘢痕数码相片的评价差异结果也支持以上论断。 结论： 从本试验有限的病例来看，对于轻度的内眦赘皮，患者对两种术式术后瘢 痕的满意度无差异；但是对于中、重度的内眦赘皮，患者对反 Z 法的术后瘢痕 满意度高于横切纵缝法。 关键词：反 Z 法； 横切纵缝法； 内眦赘皮； 瘢痕； 患者满意度 II ABSTRACT Objective: To evaluate if converse Z epicanthoplasty has any notable aesthetic impact on patients compared with transverse-vertical plasty. Method: Two hundred and two consecutive patients underwent epicanthoplasty were enrolled in this prospective randomized pilot study from February 2012 to July 2013. According to the severity of epicanthus, the patients were divided into three groups: Group A (mild) ,Group B (moderate) and Group C (severe). Then, Group A can be randomly dividied into group a1 which was using the converse Z epicanthoplasty and group a2 which the transverse-vertical plasty is adopted . Similarly, the Group B was divided into group b1 and group b2 ; Group C into group c1 and group c2 . three months later，the scar aesthetics were evaluated by patients and surgeons using the Patient and Observer Scar Assessment Scale （ POSAS ） . Meanwhile, digital photographs about scars were taken and assessed by non-research related viewers. Results: There were 198 cases who received scar aesthetic assessment in all groups. There were not any comparative demographic characteristics between Group A, Group B and Group C