曲安奈德联合5-FU治疗对耳部瘢痕疙瘩核心切除术后愈合和复发率的影响  

Effect of Triamcinolone Combined with 5-FU on Healing and Recurrence Rate after Core Excision on Auricular Keloids

作　　者：赵莉娜[1] 巩梦童 周同葵[1] 刘晓峰[1] ZHAO Lina;GONG Mengtong;ZHOU Tongkui;LIU Xiaofeng(Department of Plastic Surgery,Xuzhou Central Hospital,Xuzhou 221009,Jiangsu,China)

机构地区：[1]徐州市中心医院整形美容科,江苏徐州221009

出　　处：《中国美容医学》2024年第6期48-50,64,共4页Chinese Journal of Aesthetic Medicine

摘　　要：目的:探讨曲安奈德联合5-氟尿嘧啶(5-fluorouracil,5-FU)治疗对耳部瘢痕疙瘩患者瘢痕核心切除术后愈合和复发率的影响。方法:选取2018年1月-2022年1月在笔者医院收治的80例耳部瘢痕疙瘩患者,根据简单随机法将其分为联合组和对照组,各40例,均行耳部瘢痕疙瘩核心切除术治疗。对照组在患者术后采用5 mg/ml醋酸曲安奈德注射治疗,联合组采用5 mg/ml的5-FU联合5 mg/ml醋酸曲安奈德注射治疗,1次/4周,治疗4次。观察比较两组患者治疗后总有效率及不良反应发生情况,比较联合组和对照组患者治疗前后温哥华瘢痕量表(Vancouver scar scale,VSS)评分和视觉模拟疼痛量表(Visual analogue scale,VAS)评分,跟踪随访治疗后两组患者复发率。结果:联合组瘢痕治疗总有效率高于对照组(P<0.05),且VSS和VAS评分均低于对照组(P<0.05)。治疗期间两组不良反应发生情况相比,差异无统计学意义(P>0.05)。随访6个月和1年后联合组复发率均较对照组减少,但差异无统计学意义(P>0.05)。结论:相比于单纯使用醋酸曲安奈德注射治疗,5-FU联合醋酸曲安奈德注射可以提高耳部瘢痕疙瘩核心切除术后的美学效果,且对术后复发率无明显影响。Objective To explore the effects of triamcinolone combined with 5-fluorouracil(5-FU)on postoperative scar healing and recurrence rate after core excision in patients with auricular keloids.Methods A total of 80 patients with auricular keloids admitted to the hospital were enrolled between January 2018 and January 2022.According to simple randomization method,they were divided into combination group and control group,40 cases in each group.All patients were given core excision for auricular keloids.The control group was given triamcinolone acetate injection(5 mg/ml),while combination group was additionally given 5mg/ml of 5-FU(once/4 weeks for 4 times).The total response rate of treatment and the occurrence of adverse reactions after treatment,scores of Vancouver scar scale(VSS)and visual analogue scale(VAS)before and after treatment were compared between the two groups.The recurrence rates in the two groups were followed up after treatment.Results After treatment,differences in total response rate of scar healing between the two groups were statistically significant(P<0.05).After treatment,VSS and VAS scores in combination group were lower than those in control group(P<0.05).The difference in the occurrence of adverse reactions between the two groups was not statistically significant during treatment(P>0.05).After 6 months and 1 year of follow-up,recurrence rates in combination group were lower than those in control group,but the difference was not statistically significant(P>0.05).Conclusion Compared with triamcinolone acetate injection alone,5-FU combined with triamcinolone acetate injection can improve postoperative cosmetic effect in auricular keloid surgery,without significant effect on postoperative recurrence rate.

关 键 词：耳部瘢痕疙瘩 核心切除术 注射 美学效果 曲安奈德 5-氟尿嘧啶 

分 类 号：R764.9[医药卫生—耳鼻咽喉科]