目的 探讨A型肉毒毒素联合氟尿嘧啶在瘢痕疙瘩手术治疗中的应用。方法 选取西京医院烧伤与皮肤外科2015-07至2017-07行瘢痕疙瘩手术切除的患者68例,随机分为观察组和对照组,每组34例。其中观察组术后注射A型肉毒毒素联合氟尿嘧啶,对照组术后注射曲安奈德,比较两组患者愈合的瘢痕美容评估与评级(scar cosmesis assessment and rating,SCAR)量表评分、温哥华瘢痕评分、瘢痕疙瘩复发率及患者满意度。结果 在SCAR量表评分[(7.46±1.26)分 vs (11.51±2.33)分]、温哥华瘢痕评分[(6.31±4.16)分 vs (9.37±4.82)分]、瘢痕疙瘩复发率(5.88% vs 23.53%)及患者满意度[(9.17±0.82)分 vs (6.62±1.16)分]方面,观察组均优于对照组,差异有统计学意义(P＜0.05)。结论 瘢痕疙瘩手术后注射A型肉毒毒素联合5-氟尿嘧啶可减轻术后切口瘢痕,提高手术效果,复发率更低,患者更为满意,值得临床推广。
Abstract
Objective To investigate the applicability of surgical excisions followed by injection of botulinum toxin type A and 5-fluorouracil for keloids.Methods Sixty-eight consecutive patients who underwent surgical excisions for keloids in the Department of Burn and Skin Surgery of Xijing Hospital between July 2015 to July 2017 were enrolled.Botulinum toxin type A and 5-fluorouracil were injected into the surgical wounds of 34 patients, while triamcinolone acetonide was injected into the surgical wounds of another 34 patients. The Scar Cosmesis Assessment and Rating(SCAR), Vancouver Scar Scale score, recurrence rates and patients’levels of satisfaction were compared between the two groups.Results In terms of SCAR[(7.46±1.26) vs (11.51±2.33)],Vancouver Scar Scale score[(6.31±4.16) vs (9.37±4.82)], recurrence rates(5.88% vs 23.53%) and patients’ levels of satisfaction[(9.17±0.82) vs (6.62±1.16)], the botulinum toxin type A and 5-fluorouracil treated group was superior to the triamcinolone acetonide treated group, and the difference was statistically significant(P＜0.05).Conclusions Botulinum toxin type A and 5-fluorouracil injections can reduce the incision scars after surgical excisions for keloids, improve the surgical effect, reduce recurrence rates, and leave patients more satisfied,so this approach is worthy of clinical application.
关键词
A型肉毒毒素 /
瘢痕疙瘩 /
复发率
Key words
botulinum toxin type A /
keloid /
recurrence rates
{{custom_sec.title}}
{{custom_sec.title}}
{{custom_sec.content}}
参考文献
[1] Kim J M,Cho H J,Moon S H.Rare experience of keloidal dermatofibroma of forehead[J]. Arch Craniofac Surg,2018,19(1):72-74.
[2] Felice B,Manfellotto F,Garbi C,et al.miR-34 modulates apoptotic gene expression in Ingenol mebutate treated keloid fibroblasts[J].Mol Med Rep,2018,17(5):7081-7088.
[3] 谢 淼,郭 莉,李 燕,等. 自体脂肪移植联合肉毒毒素注射用于面部年轻化[J].河北医药杂志,2017,39(12):1866-1868.
[4] Nguyen K T, Shikowitz L, Kasabian A K,et al. A novel approach to keloid reconstruction with bilaminar dermal substitute and epidermal skin grafting[J]. Plast Reconstr Surg,2016,138(1):235-239.
[5] Kim H D, Chu S C, Hwang S M,et al. Clinical analysis of lobular keloid after ear piercing[J]. Arch Craniofac Surg,2016,17(1):5-8.
[6] Danielsen P L,Rea S M,Wood F M,et al. Verapamil is less effective than triamcinolone for prevention of keloid scar recurrence after excision in a randomized controlled trial[J]. Acta Derm Venereol,2016,23;96(6):774-778.
[7] Noishiki C,Takagi G,Kubota Y,et al. Endothelial dysfunction may promote keloid growth[J]. Wound Repair Regen,2017,25(6):976-983.
[8] Azimi S Z, Zargari O, Rudolph R I. Nodular colloid milium mimicking keloid[J]. J Cosmet Dermatol,2017,16(4):45-47.
[9] Jumper N, Hodgkinson T, Paus R,et al. Site-specific gene expression profiling as a novel strategy for unravelling keloid disease pathobiology[J]. PLoS One,2017, 12(3): 10-13.
[10] Park K Y,Lee Y,Hong J Y,et al.Vibration anesthesia for pain reduction during intralesional steroid injection for keloid treatment[J]. Dermatol Surg,2017,43(5):724-727.
[11] Chamaria A,Sousa R F,Aras M A,et al. Surgical excision and contoured custom made splint to treat helical keloid[J]. Indian J Plast Surg,2016,49(3):410-414.
[12] Leeuwen M C,Bulstra A E,Leeuwen P A,et al. A new argon gas-based device for the treatment of keloid scars with the use of intralesional cryotherapy[J]. J Plast Reconstr Aesthet Surg,2014,67(12):1703-1710.
PDF(798 KB)
