茅彦 马成 孟泽兰

[摘要]目的：探討美容缝合联合rh-bFGF眼凝胶及银离子抗菌敷料包扎用于眼部外伤处理的美容效果。方法：选取100例眼外伤患者为研究对象，均行常规清创、重组人表皮生长因子溶液喷洒创面、常规换药、可吸收缝合线进行美容缝合、加压包扎等处理，其中50例缝合后应用rb-bFGF眼凝胶外敷和银离子抗菌敷料包扎处理为观察组，另50例未应用rb-bFGF眼凝胶作为对照组，评估两组疗效，观察两组创面愈合情况、术后并发症发生情况，调查两组创口美容满意度。结果：观察组的临床总有效率为98.00%，较对照组高（80.00%），差异有统计学意义（P<0.05）。观察组用药3d后可见伤口平整，针眼附近附近未见明显红肿，创口有细小线状瘢痕;而对照组眼针周围红肿，多数创面存在渗液;观察组的创面愈合时间、创口表皮生长时间均显著少于对照组，差异有统计学意义（P<0.05）。观察组均未见明显创面肉芽组织过度增生，未出现感染病例，其不良反应总发生率显著低于对照组（0.00% vs 12.00%，P<0.05）。观察组的创口美容满意度为98.00%，显著高于对照组的86.00%，差异有统计学意义（P<0.05）。结论：美容缝合联合rh-bFGF眼凝胶及银离子抗菌敷料包扎用于眼部外伤处理美容效果显著，能快速促进创面愈合，未出现明显术后并发症，可提高患者的创口美容满意度。

[关键词]美容缝合;rb-bFGF眼凝胶;银离子抗菌敷料;眼部外伤;美容效果;满意度

[中图分类号]R622    [文献标志码]A    [文章编号]1008-6455（2021）06-0036-03

Analysis of Cosmetic Effect of Cosmetic Suture Combined with rh-bFGF Eye Gel and Silver Ion Antibacterial Dressing in Treatment of Ocular Trauma

MAO Yan，MA Cheng，MENG Ze-lan

（Department of Ophthalmology，942 Hospital，Joint Logistics Support Force of PLA， Yinchuan 750004，Ningxia，China）

Abstract： Objective  To investigate the cosmetic effect of cosmetic suture combined with rh-bFGF eye gel and silver ion antibacterial dressing in the treatment of ocular trauma. Methods  Totally 100 cases of patients with ocular trauma were selected as the study subjects， and all of them underwent conventional debridement， spraying of wound with recombinant human epidermal growth factor solution， routine dressing change， absorbable stitches for cosmetic suture， compression bandaging and other treatments. Among them， 50 cases treated with external application of rh-bFGF eye gel and silver ion antibacterial dressing after suture were set as the observation group， and the other 50 cases who were not treated with rh-bFGF eye gel were set as the control group. The efficacy was evaluated in the two groups， and the wound healing and occurrence of postoperative complications were observed in the two groups， and the wound beauty satisfaction was investigated in the two groups. Results  The total clinical effective rate in the observation group was 98.00%， which was significantly higher than that in the control group （80.00%）， the difference was statistically significant （P<0.05）. In the observation group， the wound was flat after 3d of medication， and there was no obvious redness and swelling near the needle eye， and there were small linear scars on the wound. In the control group， there was redness and swelling around the eye needle and exudate on most of the wounds. The wound healing time and wound epidermal growth time of the observation group were significantly less than those of the control group （P<0.05）. There was no obvious overgrowth of granulation tissue and infection in the observation group， and the total incidence of adverse reactions in the observation group was significantly lower than that in the control group （0.00% vs 12.00%， P<0.05）. The wound beauty satisfaction was 98.00% in the observation group， which was significantly higher than that in the control group （86.00%， P<0.05）. Conclusion  Cosmetic suture combined with rh-bFGF eye gel and silver ion antibacterial dressing has a significant cosmetic effect in the treatment of ocular trauma. It can quickly promote wound healing， without obvious postoperative complications， and improve the wound beauty satisfaction of patients.

Key words： cosmetic suture; rh-bFGF eye gel; silver ion antibacterial dressing; ocular trauma; cosmetic effect; satisfaction

眼外伤是指由于外来化学性或物理性因素直接或间接作用于眼部，导致眼球及其附属器的结构或生理功能被破坏的损伤，皮肤外伤修复术是常用术式，但由于外伤清创缝合、麻醉浸润等因素会造成眼局部组织水肿瘀血加重，影响眼部创面修复效果[1]。人体眼周围皮肤娇嫩、浅薄，人们对眼部创面修复美容度要求也相对更高，这不仅要求拥有精湛缝合技术，还要求临床更佳注重眼外伤术后护理，以减少术后增生性瘢痕，提高创面修复质量[2]。美容缝合是常用颌面外伤缝合处理方式，但术后瘢痕存在过度增生情况，影响面部美容度，临床多需结合促表皮生长因子治疗[3]。重组牛碱性成纤维细胞生长因子（Recombinant bovine basic fibroblast growth factor，rb-bFGF）眼凝膠是一种创面成纤维细胞的趋向剂和促进创面新生毛细血管内皮细胞生长的刺激剂，具有愈合效果佳、换药简单、无疼痛等优点，常应用眼部创面修复中能明显改善瘢痕增生等问题[4]。……