医用胶在头皮裂伤中应用的可行性研究

摘要

Objective To investigate the feasibility of applying tissue adhesives in scalp laceration by comparing the advantages and disadvantages of tissue adhesives and conventional debridement and suture in the treatment of scalp laceration. Methods A total of 152 patients with scalp laceration who received treatment in Department of Emergency Medicine of the Affiliated Hospital of Southwest Medical University from July 2015 to July 2016 were selected and randomly divided into control group(n = 73)and observation group(n = 79)by random number table method. Patients in control group received conventional debridement and suture under local anesthesia,while the observation group used hair weaving and tissue adhesives to glue the wound. The operation time,pain degree,total cost and satisfaction degree of the two groups were recorded. Results The average operation time(9. 5 ± 2. 7)min in the observation group was significantly shorter than(14. 5 ± 3. 5)min in the control group,the visual analogue scale(VAS)3(0,4)was significantly less than 5(2,8),and the total cost 560(560,588) yuan was significantly more than 318 ( 300,330 ) yuan( P < 0. 05 ). In the control group,22 cases( 30. 1% ) were dissatisfied,32 cases(43. 8% )were quite satisfied and 19 cases(26. 1% )were satisfied;in the observation group,5 cases (6. 3% )were dissatisfied,20 cases(25. 3% )were quite satisfied and 54 cases(68. 4% )were satisfied. There was significant difference in the satisfaction degree between the two groups(U = 30. 064,P < 0. 001). Conclusion Applying tissue adhesives in gluing the scalp has short operative time and mild degree of pain. Although its total cost is higher than that of conventional debridement,the patients′ satisfaction degree is relatively high. It is feasible to apply tissue adhesives in the treatment of scalp laceration,and tissue adhesives are suitable for clinical promotion.%目的：通过比较医用胶和常规清创缝合在头皮裂伤处理时的优劣，探讨医用胶在头皮裂伤中应用的可行性。方法选取2015年7月—2016年7月在西南医科大学附属医院急诊医学部就诊的头皮裂伤患者152例，采用随机数字表法将患者分为对照组（n =73）和观察组（n =79）。对照组采用常规局部麻醉下清创缝合，观察组采用头发交织加医用胶粘合创口。记录两组手术时间、疼痛程度、总费用及满意度。结果观察组手术时间（9.5±2.7） min短于对照组的（14.5±3.5）min，视觉模拟评分（VAS）3（0，4）分低于对照组的5（2，8）分，总费用560（560，588）元高于对照组的318（300，330）元，差异均有统计学意义（P <0.05）。对照组不满意22例（30.1%），比较满意32例（43.8%），满意19例（26.1%）；观察组不满意5例（6.3%），比较满意20例（25.3%），满意54例（68.4%）。两组患者满意度比较，差异有统计学意义（U =30.064，P <0.001）。结论医用胶粘合头皮具有手术时间短，疼痛程度轻，尽管总费用较常规清创高，但患者满意度较高。医用胶在处理头皮裂伤具有可行性，适合临床推广使用。