不同浓度5-氟尿嘧啶联合曲安奈德治疗耳廓瘢痕疙瘩的效果观察  

Efficacy of different concentrations of 5-fluorouracil combined with triamcinolone acetonide in treatment of auricular keloids

作　　者：潘盛盛[1] 倪彬婷[1] 何玉仓 PAN Shengsheng;NI Binting;HE Yucang(Department of Plastic Surgery,the First Affiliated Hospital of Wenzhou Medical University,Wenzhou 325000,China)

机构地区：[1]温州医科大学附属第一医院整形外科,325000

出　　处：《浙江医学》2022年第7期737-741,共5页Zhejiang Medical Journal

摘　　要：目的观察不同浓度5-氟尿嘧啶联合曲安奈德治疗耳廓瘢痕疙瘩的临床效果。方法选取2016年1月至2020年12月在温州医科大学附属第一医院接受诊治的耳廓瘢痕疙瘩患者150例。其中50例患者采用曲安奈德治疗,为对照组;50例患者采用低浓度5-氟尿嘧啶(1.0 mg/ml)联合曲安奈德治疗,为低浓度联合治疗组;另50例患者采用高浓度5-氟尿嘧啶(5.0 mg/ml)联合曲安奈德治疗,为高浓度联合治疗组。比较3组患者临床疗效、临床症状改善程度、不良反应发生情况。结果高浓度联合治疗组患者临床治疗有效率(92.00%)高于低浓度联合治疗组(74.00%)、对照组(60.00%)(均P<0.05)。治疗前,3组患者温哥华瘢痕量表(VSS)评分、耳廓瘢痕疙瘩疼痛和瘙痒程度视觉模拟评分量表(VAS)评分比较差异均无统计学意义(均P>0.05);治疗3个月后,3组患者VSS、VAS评分均明显低于治疗前(均P<0.05),高浓度联合治疗组患者VSS、VAS评分明显低于低浓度联合治疗组、对照组(均P<0.05)。高浓度联合治疗组患者不良反应发生率(10.00%)明显低于低浓度联合治疗组(24.00%)、对照组(26.00%)(均P<0.05)。结论与采用单纯曲安奈德及采用低浓度5-氟尿嘧啶联合曲安奈德治疗相比,采用高浓度5-氟尿嘧啶联合曲安奈德治疗耳廓瘢痕疙瘩患者临床效果更好,能够有效改善耳廓瘢痕疙瘩患者疼痛和瘙痒程度,有利于缓解临床症状,效果安全可靠。Objective To compare the efficacy of different concentrations of 5-fluorouracil combined with triamcinolone acetonide in treatment of auricular keloids.Methods A total of 150 patients with auricular keloids treated in the First Affiliated Hospital of Wenzhou Medical University from January 2016 to December 2020 were enrolled in the study.Among them,50 patients were treated with triamcinolone acetonide(control group),50 patients were treated with low-concentration 5-fluorouracil(1.0 mg/ml)combined with triamcinolone acetonide(low dose combination group)and 50 patients were treated with highconcentration 5-fluorouracil(5.0 mg/ml)combined with triamcinolone acetonide(high dose combination group).The clinical efficacy,improvement of symptoms,and adverse reactions were compared among the three groups.Results The clinical effective rate of the high dose combination group(92.00%)was higher than that of the low dose combination group(74.00%)and the control group(60.00%)(P<0.05).Before treatment,there was no significant difference in Vancouver scar scale(VSS)score,auricular keloid pain and pruritus visual analog scale(VAS)score among the three groups(P>0.05).After 3 months of treatment,the VSS and VAS scores were significantly lower than those before treatment(all P<0.05)in all three groups.While the VSS and VAS scores of the high dose combination group were significantly lower than those of other two group(P<0.05).The incidence of adverse reactions in the high dose combination group(10.00%)was significantly lower than that in the low dose combination group(24.00%)and the control group(26.00%)(both P<0.05).Conclusion Compared with triamcinolone acetonide alone and low dose 5-fluorouracil combined with triamcinolone acetonide,the clinical effect of high dose 5-fluorouracil combined with triamcinolone acetonide is better and safer in the treatment of patients with auricular keloids,and it can effectively improve symptoms of auricular keloids.

关 键 词：耳廓瘢痕 瘢痕疙瘩 不同浓度 5-氟尿嘧啶 曲安奈德 

分 类 号：R764[医药卫生—耳鼻咽喉科]