曲安奈德注射联合复方肝素钠尿囊素凝胶和A型肉毒毒素注射对手腕部疤痕疗效的临床效果比较  

Comparison of Efficacy and Safety Between Botulinum Toxin Type A and Triamcinolone Acetonide plus Compound Heparin Sodium Allantoic Gel in the Treatment of hyperplastic scar

作　　者：李天尹 林献青[1] 朱智敏[2] 鲍晓[1] 阳纯兵[1] LI Tian-Yin;LINXian-Qing;ZHU Zhi-Min;BAO Xiao;YANG Chun-Bing(Yue Bei People's Hospital,Guangdong Shaoguan 512026;Lian Jiang People's Hospital,Guangdong Lianjiang 524400)

机构地区：[1]粤北人民医院,广东韶关512026 [2]廉江市人民医院,广东廉江

出　　处：《按摩与康复医学》2021年第18期66-68,72,共4页Chinese Manipulation and Rehabilitation Medicine

基　　金：2020年韶关市卫生健康科研计划项目,编号:Y20268。

摘　　要：目的:研究曲安奈德注射联合复方肝素钠尿囊素凝胶和A型肉毒毒素注射对手腕部疤痕疗效的临床效果比较。方法:选取2017年11月~2020年1月粤北人民医院手外伤导致手腕部疤痕住院患者126例,根据入选标准以及排除标准,最终90例患者入选。入选患者随机分为观察组和对照组各45例。所有患者均接受常规增生性疤痕康复治疗,观察组采用曲安奈德注射联合复方肝素钠尿囊素凝胶,对照组采用A型肉毒毒素注射。5周后对所有患者进行干预前后温哥华疤痕评分量表(Vancouver Scar Scale,VSS)瘢痕皮损厚度,腕关节活动度评定。结果:治疗后,两组患者的VSS评分、疤痕厚度均较治疗前降低(P<0.05),腕屈角度、背伸角度均较治疗前增大(P<0.05),且观察组治疗后的VSS评分、疤痕厚度、腕屈角度、背伸角度均优于对照组(P<0.05)。观察组不良反应发生率低于对照组(P<0.05)。结论:A型肉毒毒素注射可以明显改善手腕部增生性疤痕性状和腕部关节活动度。Objective:Objective To compare the clinical effects of triamcinolone acetonide injection combined with compound heparin sodium allantoin gel and botulinum toxin type A injection of hand wrist scar.Methods:A total of 126 ho spitalized patients with wrist scar caused by hand trauma in North Guangdong People’s Hospital from November 2017 to January 2020 were selected.According to the inclusion criteria and exclusion criteria,90 patients were finally selected.The enrolled patients were randomly divided into observation group and control group,45 cases in each.All patients received conventional hypertrophic scar rehabilitation treatment,the observation group received triamcinolone acetonide injection combined with compound heparin sodium allantoin gel,and the control group received botulinum toxin type A injection.After 5 weeks,all patients were assessed on the Vancouver Scar Scale(VSS) before and after intervention for Scar skin thickness and wrist range of motion.Results:After treatment,VSS score and scar thickness in 2 groups were decreased compared with before treatment(P<0.05),while carpal flexion Angle and dorsiflexion Angle were increased compared with before treatment(P<0.05),and the VSS score,scar thickness,carpal flexion Angle and dorsiflexion Angle in observation group were better than those in control group(P<0.05).The incidence of adverse reactions in observation group was lower than that in control group(P<0.05).Conclusions:Botulinum toxin A injection can significantly improve the wrist hyperplastic scar character and wrist range of motion.

关 键 词：增生性疤痕 A型肉毒毒素 曲安奈德 温哥华疤痕评分量表 

分 类 号：R74[医药卫生—神经病学与精神病学]