两种方法治疗瘢痕疙瘩的前瞻性研究

doi:10.6040/j.issn.1671-7554.0.2014.153

山东大学学报（医学版） ›› 2014, Vol. 52 ›› Issue (8): 85-89.doi: 10.6040/j.issn.1671-7554.0.2014.153

两种方法治疗瘢痕疙瘩的前瞻性研究

孙玉凯¹, 李中华¹, 王海琴², 芦昌慧¹, 杨波¹, 王一民¹

1. 济南市第四人民医院烧伤整形科, 山东济南 250031;
2. 济南市第五人民医院妇产科, 山东济南 250021

收稿日期:2014-03-20 修回日期:2014-05-28 出版日期:2014-08-10 发布日期:2014-08-10
通讯作者: 王一民。E-mail：yuan2830@163.com E-mail:yuan2830@163.com
基金资助:
济南市卫生局科技计划（2008-20）

A randomized prospective study on the clinical effect of two treatments on keloids

SUN Yukai¹, LI Zhonghua¹, WANG Haiqin², LU Changhui¹, YANG Bo¹, WANG Yimin¹

1. Department of Burns and Plastic Surgery, Jinan Fourth People's Hospital, Jinan 250031, Shandong, China;
2. Department of Obstetrics and Gynecology, Jinan Fifth People's Hospital, Jinan 250021, Shandong, China

Received:2014-03-20 Revised:2014-05-28 Online:2014-08-10 Published:2014-08-10

摘要/Abstract

摘要： 目的比较二氧化碳点阵激光联合³²P敷贴和二氧化碳点阵激光联合复方倍他米松注射治疗瘢痕疙瘩的临床效果。方法选取70例瘢痕疙瘩患者，采用随机、开放的前瞻性研究方法，将其分为二氧化碳点阵激光联合³²P敷贴组（A组，36例）和二氧化碳点阵激光联合复方倍他米松注射组（B组，34例）。2组均先采用二氧化碳点阵激光治疗，后采用重组人表皮生长因子凝胶进行换药。创面愈合24 h内，A组给予³²P敷贴0.4~0.8 MBQ/cm²治疗，B组行局部复方倍他米松注射治疗，每月1次，连用3次。比较2组患者的临床疗效、症状改善情况、患者满意度和不良反应的发生率。结果 A组的治愈率和满意度高于B组的治愈率和满意度（χ²=5.884，t=2.193，P<0.05）；A、B两组患者治疗后温哥华瘢痕量表评分、疼痛评分、瘙痒评分均较治疗前有所降低（t=30.070、14.797、11.889，t=18.049、10.016、8.290，P<0.01），治疗后A组上述评分均低于B组（t=5.861、5.480、3.069，P<0.01）。结论二氧化碳点阵激光联合³²P敷贴治疗，能明显提高临床疗效，改善症状，但技术有待改进。

关键词: 点阵激光, ³²P敷贴, 复方倍他米松注射液, 瘢痕疙瘩, 重组人表皮生长因子

Abstract: Objective To evaluate the effect of two treatment approaches on keloids: fractional CO₂ laser combined with ³²P applicator, and fractional CO₂ laser combined with intralesional injection of compound betamethasone. Methods A total of 70 patients were divided into two groups: group A (n=36) treated with fractional CO₂ laser combined with ³²P applicator, and group B (n=34) treated with fractional CO₂ laser combined with intralesional injection of compound betamethasone. All patients received fractional CO₂ laser therapy first and then recombinant human epidermal growth factor gel. After the wound healed, patients in group A received ³²P applicator therapy, 0.4~0.8 MBQ/cm² for 96 hours; patients in group B received compound betamethasone injection therapy, once every month for 3 times. The clinical effect, symptoms, satisfaction and ratio of side effects between the two groups were compared. Results The cure rate and satisfaction in group A were, which were significantly higher than those in group B(χ²=5.884, t=2.193, P<0.05). The Vancouver Scar Scale (VSS) scores, pain scores, and itch scores were significantly improved in both groups after treatment (t=30.070, 14.797, 11.889; t=18.049, 10.016, 8.290, P<0.01); the above items in group A were significantly lower than those in group B after comprehensive intervention (t=5.861, 5.480, 3.069, P<0.01). Conclusion Fractional CO₂ laser combined with ³²P applicator is highly effective on keloids with satisfactory clinical results. However, the technique still needs improvement.

Key words: Keloid, Fractional laser, 32P applicator, Compound betamethasone, Recombinant human epidermal growth factor

中图分类号:

R622+9

孙玉凯, 李中华, 王海琴, 芦昌慧, 杨波, 王一民. 两种方法治疗瘢痕疙瘩的前瞻性研究[J]. 山东大学学报（医学版）, 2014, 52(8): 85-89.

SUN Yukai, LI Zhonghua, WANG Haiqin, LU Changhui, YANG Bo, WANG Yimin. A randomized prospective study on the clinical effect of two treatments on keloids[J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2014, 52(8): 85-89.

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两种方法治疗瘢痕疙瘩的前瞻性研究

A randomized prospective study on the clinical effect of two treatments on keloids

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