曲安奈德与A型肉毒毒素联合注射治疗瘢痕疙瘩的疗效观察  

Efficacy observation of triamcinolone acetonide combined with botulinum toxin type A injection in the treatment of keloid

作　　者：柳承业 徐凯 林瀚 LIU Cheng-ye;XU Kai;LIN Han(Deparment of Plastic Surgery,Jimo Disrict Qingdao Hospiral of Traditionad Chinese Medicine,Qingdao 266000,China)

机构地区：[1]青岛市即墨区中医医院整形外科,山东青岛266000

出　　处：《中国美容整形外科杂志》2020年第7期430-432,I0008,共4页Chinese Journal of Aesthetic and Plastic Surgery

摘　　要：目的观察曲安奈德联合A型肉毒毒素(botulinum toxin type A, BTX-A)注射治疗后行SRT-100 X线照射治疗瘢痕疙瘩的长期疗效。方法将自2016年9月至2017年9月收治的30例瘢痕疙瘩患者随机分为A组(15例)和B组(15例)。A组于瘢痕疙瘩内注射曲安奈德,每4周1次,共5次;B组于瘢痕疙瘩内注射曲安奈德后30 min在瘢痕疙瘩基底部注射BTX-A,2.5 U/点,每点间隔1.0 cm,每4周1次,共5次。两组在注射治疗后均采用SRT-100 X线照射,4 Gy/次,共5次,采用温哥华瘢痕评分量表与可视对比评分量表对两组治疗前后瘢痕疙瘩的整体情况进行评分,并比较两组患者治疗前后总评分差值以及治疗后的显效程度。结果两组患者治疗后的效果均较满意。B组总体显效程度高于A组(z=-2.49,P=0.01)。A组和B组患者治疗前后总评分差值分别为(5.13±1.36)分、(8.67±1.05)分,两组比较其差异具有统计学意义(t=7.99,P<0.05)。结论采用曲安奈德联合BTX-A注射后行SRT-100 X线照射治疗是预防瘢痕疙瘩复发的有效措施,值得临床推广应用。Objective To observe the long-term efficacy of SRT-100 X ray irradiation after triamcinolone acetonide combined with botulinum toxin type A(BTX-A)injection in the treatment of keloid.Methods From September 2016 to 2017,30 patients with keloid were admitted to hospital and randomly divided into group A and B,15 patients in each group.In group A,triamcinolone acetonide was injected into the keloid once every 4 weeks,a total of 5 times.In group B,BTX-A was injected into the keloid at 30 min after triamcinolone acetonide injection.The injection dose was 2.5 U for per point and the interval was 1.0 cm.The injection was once every 4 weeks,a total of5 times.Both groups received SRT-100 X ray irradiation after injection,4 Gy per time,a total of 5 times.The vancouver scar scale(VSS)and visual analogue scale(VAS)were used to evaluate the overall condition of keloid before and after treatment in both groups.The difference of total scores and the degree of efficacy between two groups before and after treatment were compared.Results Patients in group A and B were satisfied with the efficacy after treatment.The total efficacy rate of group B was higher than that of group A(z=-2.49,P=0.01).The difference of total scores in group A before and after treatment was(5.13±1.36)and group B was(8.67±1.05).The difference between two groups was statistically significant(t=7.99,P<0.05).Conclusion The triamcinolone acetonide combined with BTX-A and SRT-100 X ray irradiation was an effective measure to prevent the recurrence keloid.It should be considerable for clinical promotion and application.

关 键 词：瘢痕疙瘩 A型肉毒毒素 曲安奈德 X线照射 

分 类 号：R622[医药卫生—整形外科]