Song J H, Xia Z G, Zhou X L, Li X Z, Hu Z S, Li P T, Xu Q L
Department of Burns, the First Affiliated Hospital of Anhui Medical University, Hefei 230022, China.
Department of Wound Repair, Plastic and Aesthetic Surgery, the Fourth Affiliated Hospital of Anhui Medical University, Hefei 230001, China.
Zhonghua Shao Shang Za Zhi. 2021 May 20;37(5):485-489. doi: 10.3760/cma.j.cn501120-20210127-00038.
To explore the influence of parental compliance on the treatment of hypertrophic scars in burn children. 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 test, independent sample test, and paired sample test. 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 (=0.834, 0.026, 0.837, 0.076, 1.074, >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 (=5.518, 4.732, 5.042, <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 (=5.241, 5.273, 5.214, 5.245, 3.451, <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 (=3.606, 3.542, 3.448, <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 (=0.607, >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 (=2.606, <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 (=4.002, <0.01), while there was no obvious change in poor compliance group in the follow-up of 9 months (=3.550, >0.05). 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.
探讨家长依从性对烧伤患儿增生性瘢痕治疗效果的影响。采用回顾性队列研究方法。选取2014年6月至2019年6月在安徽医科大学第一附属医院烧伤科门诊就诊、符合纳入标准的49例烧伤后增生性瘢痕患儿纳入本研究。在9个月的随访期内,根据登记表及家长依从性调查问卷结果,将患儿分为依从性良好组(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)。在首次就诊及3、6、9个月随访时,采用温哥华瘢痕量表(VSS)对依从性良好组患儿的瘢痕进行评分。在首次就诊及9个月随访时,采用VSS对依从性差组患儿的瘢痕进行评分。在首次就诊及9个月随访时,采用视觉模拟评分法(VRS)对两组患儿的瘢痕瘙痒程度进行评分。数据采用卡方检验、Wilcoxon秩和检验、Mann-Whitney检验、独立样本t检验和配对样本t检验进行统计学分析。首次就诊时,两组患儿瘢痕的VSS评分中颜色、血管分布、柔软度、厚度评分及总分比较,差异均无统计学意义(P =0.834、0.026、0.837、0.076、1.074,均>0.05)。9个月随访时,依从性良好组患儿瘢痕的柔软度、厚度评分及总分均显著低于依从性差组(P =5.518、4.732、5.042,均<0.01)。与首次就诊时比较,依从性良好组患儿9个月随访时瘢痕的颜色、血管分布、柔软度、厚度评分及总分均显著降低(P =5.241、5.273、5.214、5.245、3.451,均<0.01);依从性差组患儿9个月随访时瘢痕的颜色、血管分布评分及总分均显著降低(P =3.606、3.542、3.448,均<0.01)。首次就诊时,依从性良好组患儿瘢痕瘙痒的VRS评分为6.00(5.00,6.25)分,与依从性差组的(5.47±1.69)分比较,差异无统计学意义(P =0.607,>0.05)。9个月随访时,依从性良好组患儿瘢痕瘙痒的VRS评分为1.00(1.00,1.25)分,显著低于依从性差组的(3.27±1.71)分(P =2.606,<0.01)。与首次就诊时比较,依从性良好组患儿9个月随访时瘢痕瘙痒的VRS评分显著降低(P =4.002,<0.01),而依从性差组患儿9个月随访时无明显变化(P =3.550,>0.05)。在相同治疗方案下,家长良好的依从性对烧伤患儿增生性瘢痕的治疗具有积极作用,可降低瘢痕增生程度及瘙痒程度。