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统计分析影响深度二度烧伤后瘢痕畸形儿童再次手术时间的因素。

Statistical analysis of factors affecting re-operative times in paediatric patients with scar deformity after deep second-degree burn injury.

机构信息

Plastic and Reconstructive Surgery, The First Hospital Affiliated to the People's Literative Army Hospital, Beijing, China.

出版信息

Int Wound J. 2018 Aug;15(4):565-570. doi: 10.1111/iwj.12899. Epub 2018 Mar 30.

Abstract

Deep second-degree burn injuries pose a challenge for treating scar deformity in developing paediatric patients. Some patients underwent several re-operations during their development. There was no literature reporting which factors affect re-operative times. In this article, we intend to analyse possible influential factors that are responsible for re-operative times in paediatric patients with scar deformity after deep second-degree burn injuries. From 2010 to 2016, 177 paediatric cases with a history of deep second-degree burn injury who underwent re-operation once, twice, and equal to or more than thrice were recruited to this study, with age ranging from 0 to 18 years. The following factors were analysed: age, gender, size of scar, method for reconstruction, location, postoperative anti-scar treatment, preschool group, school group, combined deformity, and combined method for reconstruction. One-way ANOVA and multi-way ANOVA analysis were used as statistical tools to analyse the above factors and re-operative times. There were 83 male cases and 94 female cases, with an average age of 7.47 years. Statistical significance was achieved for the size of scar (P = 0.000), operation method (P = 0.001), and combined deformity (P = 0.026) under 1-way ANOVA in different re-operative times. The operation methods for the head and neck area (P < 0.05) and the lower extremities (P < 0.05) are critical factors for multi-factor variance analysis in different re-operative times. Multivariate logistic regression analysis also demonstrated that the size of scar was an independent risk factor for the number of operations. Combined operative method was a protective risk factor for the number of operations. There was no statistical significance obtained for other factors. Size of scar, operation method, and combined operation method are the risk factors for re-operative times, while operation methods for the head and neck area and lower extremities are the critical factors for re-operative times. We can use the combined method to resolve scar-related problems in order to reduce re-operative times.

摘要

深度二度烧伤对治疗发育中儿童患者的瘢痕畸形构成挑战。一些患者在发育过程中经历了多次再手术。目前尚无文献报道哪些因素会影响再手术时间。在本文中,我们旨在分析可能影响深度二度烧伤后瘢痕畸形儿童患者再手术时间的因素。

2010 年至 2016 年,我们共招募了 177 例曾接受过一次、两次和等于或多于三次深度二度烧伤后再手术的小儿病例,年龄 0 至 18 岁。分析了以下因素:年龄、性别、瘢痕大小、重建方法、部位、术后瘢痕防治、学龄前组、学龄组、合并畸形、合并重建方法。采用单因素方差分析和多因素方差分析对上述因素和再手术时间进行统计学分析。

男性 83 例,女性 94 例,平均年龄 7.47 岁。单因素方差分析显示,不同再手术次数的瘢痕大小(P = 0.000)、手术方法(P = 0.001)和合并畸形(P = 0.026)差异有统计学意义。头颈部(P < 0.05)和下肢(P < 0.05)手术方法是不同再手术次数多因素方差分析的临界因素。多因素 logistic 回归分析还表明,瘢痕大小是手术次数的独立危险因素,联合手术方法是手术次数的保护因素。其他因素差异无统计学意义。

瘢痕大小、手术方法和联合手术方法是再手术时间的危险因素,头颈部和下肢手术方法是再手术时间的关键因素。我们可以使用联合方法来解决与瘢痕相关的问题,以减少再手术次数。

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