曲安奈德局部封闭治疗瘢痕疙瘩的临床效果(1)
[摘要]目的 探讨曲安奈德局部封闭治疗瘢痕疙瘩的临床效果。方法 选取2018年7～12月我院收治的60例瘢痕疙瘩患者，采用随机数字表法分为对照组(n=30)和观察组(n=30)。对照组使用醋酸泼尼松龙局部封闭治疗，观察组使用醋酸曲安奈德局部封闭治疗。比较两组临床效果、治疗前后瘢痕情况、温哥华瘢痕(VSS)评分、不良反应总发生率。结果 观察组临床治疗总有效率为93.33%，高于对照组的73.33%，差异有统计学意义(P<0.05);观察组治疗后瘢痕厚度、宽度、长度均小于对照组(P<0.05);观察组治疗后1、2个月VVS评分低于对照组(P<0.05);观察组不良反应总发生率为3.33%，低于对照组的20.00%，差异有统计学意义(P<0.05)。结论 曲安奈德治疗瘢痕疙瘩的临床效果显著，可明显改善患者瘢痕厚度、宽度及长度，安全性高。
[关键词]曲安奈德;封闭治疗;瘢痕;治疗效果
[中图分类号] R751 [文献标识码] A [文章编号] 1674-4721(2020)3(c)-0227-04
Clinical effect of Triamcinolone Acetonide in the treatment of keloid
DENG Le-ying ZHU Yong-jun
Department of Dermatology， Jiangxi Dermatology Hospital， Nanchang 330001， China
[Abstract] Objective To explore clinical effect of Triamcinolone Acetonide in the treatment of keloid. Methods A total of 60 keloid patients treated in our hospital from July to December 2018 were selected. They were divided into control group (n=30) and observation group (n=30) by random number table method. The control group was given local closure treatment with Prednisolone Acetate， while observation group was given local closure treatment with Triamcinolone Acetonide. The clinical effect， scar conditions before and after treatment， score of Vancouver scar scale (VSS)， and total incidence of adverse reactions were compared between the two groups. Results The total effective rate of clinical treatment in observation group was higher than that in control group (93.33% vs. 73.33%) (P<0.05). After treatment， thickness， width and length of scar in observation group were less than those in control group (P<0.05). At 1 and 2 months after treatment， VVS scores in observation group were smaller than those in control group (P<0.05). The total incidence of adverse reactions in observation group was lower than that in control group (3.33% vs. 20.00%)， the difference was statistically significant (P<0.05). Conclusion The curative effect of Triamcinolone Acetonide is significant effect on keloid， which can significantly improve thickness， width and length of scars， with high safety.
[Key words] Triamcinolone Acetonide; Closure treatment; Scar; Curative effect
皮膚组织因创伤使其组织病理学及外观形态发生改变，最终形成瘢痕[1]。瘢痕可分为瘢痕疙瘩、增生性瘢痕，其可发生于肩部、背部、胸部、腹部等机体任何皮肤部位[2]。瘢痕主要是皮肤创伤恢复过程中胶原蛋白过多分泌，使其大量沉积，发生胶原纤维增生[3]。瘢痕患者临床常表现为瘢痕形状不一、瘢痕部位隆起、且有较硬触感，一般伴疼痛、瘙痒及血管扩张[4]。临床使用射线照射、手术切除、药物治疗等治疗瘢痕，射线照射及手术切除对于患者机体创伤加大，且对部分患者效果不佳，易复发，故常采用药物治疗[5]。醋酸泼尼松龙是一种治疗皮肤性疾病常用糖皮质激素类药物，对瘢痕治疗有一定作用，但长期使用对患者精神状态有所影响[6]。曲安奈德对纤维细胞的增殖有抑制作用，可帮助分解胶原纤维，消除瘢痕[7]。本研究探讨曲安奈德局部封闭治疗瘢痕疙瘩的临床效果，并与醋酸泼尼松龙进行比较，现报道如下。, 百拇医药(邓乐英 朱永军)
[关键词]曲安奈德;封闭治疗;瘢痕;治疗效果
[中图分类号] R751 [文献标识码] A [文章编号] 1674-4721(2020)3(c)-0227-04
Clinical effect of Triamcinolone Acetonide in the treatment of keloid
DENG Le-ying ZHU Yong-jun
Department of Dermatology， Jiangxi Dermatology Hospital， Nanchang 330001， China
[Abstract] Objective To explore clinical effect of Triamcinolone Acetonide in the treatment of keloid. Methods A total of 60 keloid patients treated in our hospital from July to December 2018 were selected. They were divided into control group (n=30) and observation group (n=30) by random number table method. The control group was given local closure treatment with Prednisolone Acetate， while observation group was given local closure treatment with Triamcinolone Acetonide. The clinical effect， scar conditions before and after treatment， score of Vancouver scar scale (VSS)， and total incidence of adverse reactions were compared between the two groups. Results The total effective rate of clinical treatment in observation group was higher than that in control group (93.33% vs. 73.33%) (P<0.05). After treatment， thickness， width and length of scar in observation group were less than those in control group (P<0.05). At 1 and 2 months after treatment， VVS scores in observation group were smaller than those in control group (P<0.05). The total incidence of adverse reactions in observation group was lower than that in control group (3.33% vs. 20.00%)， the difference was statistically significant (P<0.05). Conclusion The curative effect of Triamcinolone Acetonide is significant effect on keloid， which can significantly improve thickness， width and length of scars， with high safety.
[Key words] Triamcinolone Acetonide; Closure treatment; Scar; Curative effect
皮膚组织因创伤使其组织病理学及外观形态发生改变，最终形成瘢痕[1]。瘢痕可分为瘢痕疙瘩、增生性瘢痕，其可发生于肩部、背部、胸部、腹部等机体任何皮肤部位[2]。瘢痕主要是皮肤创伤恢复过程中胶原蛋白过多分泌，使其大量沉积，发生胶原纤维增生[3]。瘢痕患者临床常表现为瘢痕形状不一、瘢痕部位隆起、且有较硬触感，一般伴疼痛、瘙痒及血管扩张[4]。临床使用射线照射、手术切除、药物治疗等治疗瘢痕，射线照射及手术切除对于患者机体创伤加大，且对部分患者效果不佳，易复发，故常采用药物治疗[5]。醋酸泼尼松龙是一种治疗皮肤性疾病常用糖皮质激素类药物，对瘢痕治疗有一定作用，但长期使用对患者精神状态有所影响[6]。曲安奈德对纤维细胞的增殖有抑制作用，可帮助分解胶原纤维，消除瘢痕[7]。本研究探讨曲安奈德局部封闭治疗瘢痕疙瘩的临床效果，并与醋酸泼尼松龙进行比较，现报道如下。, 百拇医药(邓乐英 朱永军)
参见：首页 > 医疗版 > 疾病专题 > 整形外科 > 瘢痕