温哥华瘢痕量表在曲安奈德治疗甲状腺术后增生性瘢痕中的应用  

Application of Vancouver scar scale in the treatment of scar with triamcinolone acetonide

作　　者：魏战杰[1] 颜家琪 杨永刚 石朋飞 江明[1] Wei Zhanjie;Yan Jiaqi;Yang Yonggang;Shi Pengfei;Jiang Ming(Department of Thyroid and Breast Surgery,Central Hospital of Wuhan,Huazhong University of Science and Technology,Wuhan 430014,China)

机构地区：[1]华中科技大学同济医学院附属武汉市中心医院甲状腺乳腺外科,430014

出　　处：《中华实验外科杂志》2022年第5期924-927,共4页Chinese Journal of Experimental Surgery

基　　金：国家自然科学基金青年基金项目 (81600366)。

摘　　要：目的探讨采用温哥华瘢痕量表(VSS)分级进行不同浓度曲安奈德注射治疗甲状腺术后颈部增生性瘢痕的临床疗效、不良反应及复发率。方法选取武汉市中心医院甲状腺术后出现增生性瘢痕患者90例,采用随机数字表法将其分为对照组和实验组,其中对照组进行瘢痕增生VSS评分,治疗上采用原浓度(1 ml∶40 mg)的曲安奈德注射治疗;实验组对瘢痕增生进行VSS分级,VSS评分11~15分为A级、6~10分为B级、1~5分为C级。治疗上分别给予曲安奈德及利多卡因1∶1、1∶2、1∶3(体积比)稀释后进行注射治疗,比较两组的瘢痕颜色评分、瘙痒评分、治疗效果、不良反应发生率以及复发率,两组间比较采用t检验、χ^(2)检验。结果对照组与实验组治疗后瘢痕颜色评分为(1.45±0.20)分和(0.75±0.16)分(t=2.236,P<0.05),瘙痒评分为(0.73±0.36)分和(0.91±0.23)分(t=1.414,P>0.05),有效率为93.3%(42/45)和91.1%(41/45)(χ^(2)=0.155,P>0.05),不良反应发生率为31.1%(14/45)和6.7%(3/45,χ^(2)=8.775,P<0.05),复发率为8.9%(4/45)和11.1%(5/45,χ^(2)=0.124,P>0.05)。结论通过VSS对甲状腺术后颈部增生性瘢痕进行分级管理并采用个体化的曲安奈德浓度注射治疗,可在保证疗效的前提下显著减轻不良反应发生率。Objective To investigate the clinical curative effects of the treatment of hypertrophic scar with triamcinolone acetonide and to choose adaptive indications by Vancouver scar scale(VSS).Methods Totally,90 patients after thyroid surgery with hypertrophic scar were included in this study.Patients were divided into two groups(control group and experimental group).The hypertrophic scars in experimental group were scored by VSS in color,luster,vascularity,thickness,softness and were classified into three grades(grade A 11-15,grade B 6-10,grade C 1-5).Correspondingly,triamcinolone acetonide and lidocaine in 1∶1,1∶2,1∶3 ratio were used for intra-lesion injection.In control group,undiluted triamcinolone acetonide was adopted.The scar color score,pruritus score,therapeutic effect,adverse reaction rate and recurernce rate were used for comparison.Results Following the treatment,the scar color score(1.45±0.20 vs.0.75±0.16,t=2.236,P<0.05),pruritus score(0.73±0.36 vs.0.91±0.23,t=1.414,P>0.05),therapeutic effect[93.3%(42/45)vs.91.1%(41/45),χ^(2)=0.155,P>0.05],adverse reaction rate[31.1%(14/45)vs.6.7%(3/45),χ^(2)=8.775,P<0.05]and recurernce rate[8.9%(4/45)vs.11.1%(5/45),χ^(2)=0.124,P>0.05]were used for the comparison between control group and experimental group.Conclusion VSS is a simple and effective method to select the patient with hypertrophic scar for individual triamcinolone acetonide treatment.

关 键 词：增生性瘢痕 曲安奈德 温哥华瘢痕量表 

分 类 号：R653[医药卫生—外科学]