瘢痕组织瓣修复术联合曲安奈德注射治疗耳廓瘢痕疙瘩
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摘要
目的:分析瘢痕组织瓣修复术联合曲安奈德注射治疗耳廓瘢痕疙瘩的临床疗效。方法:选择笔者医院2012年5月-2017年5月收治的110例耳廓瘢痕疙瘩患者,按治疗方法不同分为对照组(n=68)和研究组(n=42)。对照组采用瘢痕组织瓣修复术治疗,研究组采用瘢痕组织瓣修复术联合曲安奈德注射治疗。比较两组临床疗效,治疗前后温哥华瘢痕量表(Vancouver scar scale,VSS)评分,不良反应及复发情况。结果:研究组总有效率为92.86%(39/42)高于对照组的77.94%(53/68),差异有统计学意义(P<0.05)。治疗前,两组VSS评分比较差异无统计学意义(P>0.05);治疗后,两组VSS评分均下降,研究组低于对照组,差异有统计学意义(P<0.05)。治疗期间,对照组无明显不良反应发生,研究组不良反应发生率为4.76%(2/42),组间比较差异无统计学意义(P>0.05)。研究组术后1年复发率为4.76%(2/42)低于对照组的17.65%(12/68),差异有统计学意义(P<0.05)。结论:瘢痕组织瓣修复术联合曲安奈德注射治疗耳廓瘢痕疙瘩临床疗效较好,可促进瘢痕疙瘩修复,降低术后复发率,安全可靠。
Objective To analyze the clinical efficacy of scar tissue flap repair combined with triamcinolone acetonide injection in the treatment of auricle keloid. Methods 110 patients with auricular keloid admitted to our hospital from May 2012 to May 2017 were divided into the control group(n=68) and the research group(n=42) according to different treatment methods. The control group was treated with scar tissue flap repair. The study group was treated with scar tissue flap repair combined with triamcinolone acetonide injection. The clinical efficacy, Vancouver Scar Scale(VSS) score before and after treatment, adverse reactions and recurrence were compared between the two groups. Results The total effective rate of the study group was 92.86%(39/42) higher than that of the control group(77.94%, 53/68), the difference was statistically significant(P<0.05). Before treatment, there was no significant difference in VSS scores between the two groups(P>0.05). After treatment, the VSS scores of both groups decreased, and that of the study group was lower than that of the control group(P<0.05). During the treatment period, there were no obvious adverse reactions in the control group, and the incidence of adverse reactions in the study group was 4.76%(2/42), there was no significant difference between the two groups(P>0.05). The one year recurrence rate in the study group was 4.76%(2/42) lower than that in the control group(17.65%, 12/68, P<0.05). Conclusion The clinical effect of scar tissue flap repair combined with triamcinolone acetonide injection in the treatment of auricle keloid is superior to that of scar tissue flap repair, which can promote the repair of the auricle keloid, reduce the postoperative recurrence rate, and is safe and reliable.
Objective To analyze the clinical efficacy of scar tissue flap repair combined with triamcinolone acetonide injection in the treatment of auricle keloid. Methods 110 patients with auricular keloid admitted to our hospital from May 2012 to May 2017 were divided into the control group(n=68) and the research group(n=42) according to different treatment methods. The control group was treated with scar tissue flap repair. The study group was treated with scar tissue flap repair combined with triamcinolone acetonide injection. The clinical efficacy, Vancouver Scar Scale(VSS) score before and after treatment, adverse reactions and recurrence were compared between the two groups. Results The total effective rate of the study group was 92.86%(39/42) higher than that of the control group(77.94%, 53/68), the difference was statistically significant(P<0.05). Before treatment, there was no significant difference in VSS scores between the two groups(P>0.05). After treatment, the VSS scores of both groups decreased, and that of the study group was lower than that of the control group(P<0.05). During the treatment period, there were no obvious adverse reactions in the control group, and the incidence of adverse reactions in the study group was 4.76%(2/42), there was no significant difference between the two groups(P>0.05). The one year recurrence rate in the study group was 4.76%(2/42) lower than that in the control group(17.65%, 12/68, P<0.05). Conclusion The clinical effect of scar tissue flap repair combined with triamcinolone acetonide injection in the treatment of auricle keloid is superior to that of scar tissue flap repair, which can promote the repair of the auricle keloid, reduce the postoperative recurrence rate, and is safe and reliable.
引文
[1]Usanakornkul A,Burusapat C.A topical anesthetic and lidocaine mixture for pain relief during keloid treatment:a double-blind,randomized controlled trial[J].Dermatol Surg,2017,43(1):66-73.
[2]张谊,张璃,林孝华,等.耳垂瘢痕疙瘩综合治疗的疗效及生存质量调查[J].中华全科医学,2017,15(4):634-636.
[3]费猛,汤諹.瘢痕疙瘩术后联合放射治疗的研究新进展[J].实用皮肤病学杂志,2017,10(3):158-160.
[4]陈晓明,戴强,施文娟,等.复方倍他米松注射液联合曲安奈德注射液序贯治疗瘢痕疙瘩的有效性和安全性[J].中国医药导报,2016,13(35):24-27.
[5]曲春安,李敏,李东岳,等.维拉帕米与曲安奈德注射治疗瘢痕疙瘩的疗效比较[J].中国美容整形外科杂志,2018,29(6):366-368.
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[10]张建清,汤旭山,杨媚,等.222例瘢痕疙瘩患者术后放射治疗的疗效观察及预后影响因素分析[J].现代肿瘤医学,2016,24(20):3270-3272.
[11]李晓庆,刘文军,段建兴,等.手术联合多种干预措施治疗耳部瘢痕疙瘩疗效的网状meta分析[J].中华整形外科杂志,2018,34(12):1010.
[12]王洲冰,何乐人.耳部瘢痕疙瘩的临床研究及治疗进展[J].医学综述,2018,24(9):138-143.
[13]吴泽勇,王绥江,黄海华,等.手术切除联合不同浓度曲安奈德注射治疗耳廓瘢痕疙瘩的临床观察[J].山东医药,2016,56(17):94-95.
[14]李静,吴晓琰,陈晓栋.糖皮质激素联合A型肉毒素皮损内注射治疗瘢痕疙瘩临床疗效观察[J].临床皮肤科杂志,2017,46(9):629-632.
[15]罗洁.多功能电离子手术联合曲安奈德治疗耳廓瘢痕疙瘩的临床疗效[J].中国地方病防治杂志,2017,32(1):97.
[16]宗宪磊,宋国栋,都乐,等.曲安奈德联合得宝松注射治疗瘢痕疙瘩的效果[J].中国医药导报,2016,13(6):157-160.
[17]乔晓峰,李昕.手术联合多种方法治疗耳部瘢痕的疗效对比研究[J].临床耳鼻咽喉头颈外科杂志,2017,31(17):1341-1343.
[18]Finlay V,Burrows S,Kendell R,et al.Modified Vancouver Scar Scale score is linked with quality of life after burn[J].Burns,2017,43(4):741-746.
[2]张谊,张璃,林孝华,等.耳垂瘢痕疙瘩综合治疗的疗效及生存质量调查[J].中华全科医学,2017,15(4):634-636.
[3]费猛,汤諹.瘢痕疙瘩术后联合放射治疗的研究新进展[J].实用皮肤病学杂志,2017,10(3):158-160.
[4]陈晓明,戴强,施文娟,等.复方倍他米松注射液联合曲安奈德注射液序贯治疗瘢痕疙瘩的有效性和安全性[J].中国医药导报,2016,13(35):24-27.
[5]曲春安,李敏,李东岳,等.维拉帕米与曲安奈德注射治疗瘢痕疙瘩的疗效比较[J].中国美容整形外科杂志,2018,29(6):366-368.
[6]刘辅仁.实用皮肤科学[M].北京:人民卫生出版社,2005:1101-1102.
[7]Busche MN,Thraen AJ,Gohritz A,et al.Burn scar evaluation using the cutometer?MPA 580 in comparison to “patient and observer scar assessment scale” and “vancouver scar scale”[J].J Burn Care Res,2018,39(4):516-526.
[8]Jones ME,McLane J,Adenegan R,et al.advancing keloid treatment:a novel multimodal approach to ear keloids[J].Dermatol Surg,2017,43(9):1164-1169.
[9]袁熙航,吕长胜.耳部瘢痕疙瘩手术切除联合术后放疗的研究进展[J].中国美容整形外科杂志,2018,29(2):96-98,131.
[10]张建清,汤旭山,杨媚,等.222例瘢痕疙瘩患者术后放射治疗的疗效观察及预后影响因素分析[J].现代肿瘤医学,2016,24(20):3270-3272.
[11]李晓庆,刘文军,段建兴,等.手术联合多种干预措施治疗耳部瘢痕疙瘩疗效的网状meta分析[J].中华整形外科杂志,2018,34(12):1010.
[12]王洲冰,何乐人.耳部瘢痕疙瘩的临床研究及治疗进展[J].医学综述,2018,24(9):138-143.
[13]吴泽勇,王绥江,黄海华,等.手术切除联合不同浓度曲安奈德注射治疗耳廓瘢痕疙瘩的临床观察[J].山东医药,2016,56(17):94-95.
[14]李静,吴晓琰,陈晓栋.糖皮质激素联合A型肉毒素皮损内注射治疗瘢痕疙瘩临床疗效观察[J].临床皮肤科杂志,2017,46(9):629-632.
[15]罗洁.多功能电离子手术联合曲安奈德治疗耳廓瘢痕疙瘩的临床疗效[J].中国地方病防治杂志,2017,32(1):97.
[16]宗宪磊,宋国栋,都乐,等.曲安奈德联合得宝松注射治疗瘢痕疙瘩的效果[J].中国医药导报,2016,13(6):157-160.
[17]乔晓峰,李昕.手术联合多种方法治疗耳部瘢痕的疗效对比研究[J].临床耳鼻咽喉头颈外科杂志,2017,31(17):1341-1343.
[18]Finlay V,Burrows S,Kendell R,et al.Modified Vancouver Scar Scale score is linked with quality of life after burn[J].Burns,2017,43(4):741-746.
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