注射法和手术法治疗瘢痕疙瘩效果比较  

OPERATION VERSUS INJECTION: A COMPARISON FOR THE TREATMENT OF KELOID

作　　者：盖君[1] 刘文阁[2] 

机构地区：[1]青岛大学医学院松山医院美容科,青岛266021 [2]北京黄寺美容外科医院

出　　处：《青岛大学医学院学报》2002年第2期172-173,共2页Acta Academiae Medicinae Qingdao Universitatis

摘　　要：①目的　比较注射法和手术法治疗瘢痕疙瘩的效果。②方法　将 32例病人分A ,B组 ,A组采用以注射为主的综合疗法 ,应用特制的高压瘢痕注射器向瘢痕组织内注射确炎舒松A混悬液 ,注射间期瘢痕外涂去疤霜 ,再用透明敷料安舒妥密封 ,以使药物充分发挥作用和避免玷污衣物。B组采用以手术为主的综合疗法。术前1～ 2周在瘢痕组织的周围及基底部注射确炎舒松A混悬液 1～ 2次 ,然后将瘢痕全层切除。术后第 3周 ,切口处皮内注射少量药物 ,并配合安舒妥继续减张并密封药物于切口处 ,以防止切口展宽和瘢痕增生。③结果　A组 84块瘢痕达到治愈、显效、无效标准者分别有 5 7,2 6 ,1块 ,治愈率为 6 8% ,总有效率为 98% ;B组 32块瘢痕达到治愈、显效、无效标准者分别为 12 ,14 ,6块 ,治愈率为 37% ,总有效率为 81% ,两组疗效比较差异有显著性 (uc =5 .0 3,P <0 .0 5 )。④结论　以注射为主的综合疗法有效率高 ,但美容效果差。以手术为主的综合疗法可缩小皮损面积 ,但复发率较高。因此 ,应根据具体情况选择合适的治疗方法。Objective\ To compare the effects of keloid treated with operation and injection.\ Methods\ 32 cases with keloid were divided into groups A and B. In Group A, triamcinolone solution was injected into keloid tissue and ointment was besmeared on keloid surface and covered with dressing. In Group B, triamcinolone solution was injected into keloid tissue 1-2 weeks before operation, and the lesion was then completely resected. A small amount of drug was injected into the incision 3 weeks after the operation to prevent scar formation.\ Results\ Group A (84 scars): cure, response and un response were 57, 26, and 1 respectively, the cure rate being 68%, and the total response rate 98%. Group B (32 scars): cure, response and un response were 12, 14 and 6 respectively, the cure rate being 37% and the total response rate 81%. The difference was significant between the two groups( u c=5.03, P <0.05).\ Conclusion\ The combination treatment (mainly by injection) has the advantage of high response rate but is poor in improving ones looks; operations may reduce the size of the lesion but with high recurrence rate. The treatment, therefore, should be carried in accordance with the individual condition.

关 键 词：瘢痕疙瘩 外科手术 药物疗法 

分 类 号：R622[医药卫生—整形外科]