探讨年龄分层在儿童面部外伤瘢痕的差异化诊断与治疗中的应用价值。

回顾性分析2024年6月至2025年12月安徽省儿童医院烧伤整形外科接受标准化治疗的186例面部外伤患儿临床资料，按年龄分为幼儿期组(1~3岁，92例)和学龄期组(6~12岁，94例)。采用独立样本t检验或χ²检验，比较两组患儿术后3个月瘢痕宽度、温哥华瘢痕量表(VSS)评分、并发症发生率和瘢痕相关自觉症状等。采用多因素线性回归分析瘢痕宽度和VSS评分的影响因素。

学龄期组瘢痕宽度[(0.78±0.23)mm]低于幼儿期组[(0.92±0.28)mm](t＝9.578，P<0.01)；VSS总分[(3.02±1.03)分]、厚度[(0.82±0.36)分]、柔软度[(0.55±0.27)分]低于幼儿期组[(3.56±1.08)分、(1.05±0.41)分、(0.74±0.30)分]，均差异有统计学意义(t＝3.218，3.875，4.012；均P< 0.01)。两组术后并发症(感染、线结排异、瘢痕增生)和瘢痕相关自觉症状(疼痛、瘙痒、灼热感)发生率比较，均差异无统计学意义(χ²＝1.258，1.784；均P> 0.05)。多因素线性回归分析显示，年龄(幼儿期)(β＝0.215，95%CI：0.054~0.376)、伤口宽度(β＝0.326，95%CI：0.147~0.505)是瘢痕宽度再增加的影响因素(t＝2.622，3.582；均P< 0.01)；年龄(幼儿期)(β＝0.198，95%CI：0.049~0.347)、伤口长度(β＝0.287，95%CI：0.119~0.455)是VSS评分升高的影响因素(t＝2.605，3.376；均P< 0.05)。

儿童面部外伤瘢痕预后存在年龄差异，需基于年龄分层实施个体化诊断与治疗，以改善预后。

To investigate the clinical value of age stratification in the differential diagnosis and treatment of facial trauma scars in children.

A retrospective analysis was conducted on the clinical data of 186 children with facial trauma who received standardized treatment at the Department of Burns and Plastic Surgery, Anhui Provincial Children′s Hospital, between June 2024 and December 2025. The patients were stratified by age into a toddler group (1-3 years, n=92) and a school-age group (6-12 years, n=94). Independent-samples t tests or chi-square tests were used to compare scar width, Vancouver Scar Scale (VSS) scores, complication rates, and scar-related subjective symptoms between the 2 groups at 3 months postoperatively. Multiple linear regression analysis was performed to identify the influencing factors for scar width and VSS scores.

The postoperative scar width in the school-age group [(0.78±0.23)mm] was significantly lower to that in the toddler group[(0.92±0.28)mm](t=9.578, P< 0.01). Furthermore, the total VSS scores (3.02±1.03), scar thickness (0.82±0.36), and scar pliability (0.55±0.27) in the school-age group were significantly lower than those in the toddler group (3.56±1.08, 1.05±0.41, and 0.74±0.30, respectively) (t=3.218, 3.875, 4.012, all P< 0.01). There were no statistically significant differences between the 2 groups regarding the incidence of postoperative complications (infection, suture reaction, and hypertrophic scarring) and scar-related subjective symptoms (pain, pruritus, and burning sensation) (χ²=1.258, 1.784, all P> 0.05). Multiple linear regression analysis demonstrated that age (toddler period) (β=0.215, 95%CI: 0.054-0.376) and initial wound width (β=0.326, 95%CI: 0.147-0.505) were significant influencing factors for the further increase of scar width (t=2.622, 3.582, all P<0.01). Furthermore, age (toddler period) (β=0.198, 95%CI: 0.049-0.347) and inith wound length (β=0.287, 95%CI: 0.119-0.455) were significantly influencing factors for the elevation of VSS scores (t=2.605, 3.376, all P< 0.05).

There are age-related differences in the prognosis of facial traumatic scars in children. Individualized diagnosis and treatment based on age stratification are needed to improve the prognosis.