摘要
目的探讨A型肉毒毒素联合复方倍他米松治疗大面积增生性瘢痕的临床效果。方法回顾性分析2017年3月至2019年3月于北部战区总医院烧伤整形科收治的39例大面积增生性瘢痕患者的临床资料,根据采用的治疗方法分为A组:A型肉毒毒素联合复方倍他米松瘢痕内注射组(13例);B组:A型肉毒毒素瘢痕内注射组(12例);C组:复方倍他米松瘢痕内注射组(14例)。记录治疗的总有效率,参照温哥华瘢痕评分量表(vancouver scar score sheet,VSS)对3组患者的瘢痕色泽、血管分布、柔软度进行综合评分;采用彩色多普勒超声诊断仪测量瘢痕厚度,并参照视觉模拟评分量表(visual analogue scale,VAS)评价患者的痛痒觉改善情况;记录不良反应发生情况;随访6个月。结果A组的总有效率(92.31%)、VSS值、瘢痕厚度、VAS值评价均明显优于B组(75.00%)和C组(50.00%),其差异有统计学意义(P<0.05)。A、B组经3次治疗后,痛痒症状明显缓解,病情趋于稳定。治疗6个月随访时A组患者未再复发,B组复发2例。3组中有极个别患者在治疗后偶发针孔周围皮肤红肿,于1~2 d自行缓解,未发生严重的不良反应。结论A型肉毒毒素联合复方倍他米松治疗大面积增生性瘢痕安全有效,能提高单次治疗的有效面积及效果并减少激素用量及其并发症,值得临床推广应用。
Objective To explore the clinical efficacy of botulinum toxin type A combined with compound betamethasone in the treatment of large area of hypertrophic scar.Methods From March 2017 to march 2019,39 patients with large area of hypertrophic scar were selected.All patients were divided into 3 groups according to the random number table.In group A,13 patients were treated by botulinum toxin type A combined with compound betamethasone injection.In group B,12 patients were treated by botulinum toxin type A injection.In group C,14 patients were treated by compound betamethasone injection.The total effective rate was recorded.The color,vascular distribution and softness of hypertrophic scar in 3 groups were evaluated based on Vancouver Scar Score Scale(VSS).The thickness of scar was measured by color Doppler ultrasound.The improvement of patients’pain and itch was evaluated according to Visual Analog Scale(VAS).All patients were followed up for 6 months.The adverse reactions were recorded.Results The total effective rate(92.31%),VSS value,thickness of scar and VAS value in group A were significantly better than those in group B(75.00%)and group C(50.00%).The difference was statistically significant among 3 groups(P<0.05).After treatment for 3 times,the symptoms of pain and itch were obviously relieved.There was no recurrence in group A and 2 cases of recurrence in group B at 6 months.Occasional redness and swelling around the injection occurred in 3 groups and relieved after 1 to 2 days.No sever adverse reactions occurred.Conclusion The botulinum toxin type A combined with compound betamethasone is safe and effective in the treatment of large area of hypertrophic scar.This method can improve the efficacy of single treatment,reduce the dosage of hormone and occurrence of complications.It should be considerable for clinical promotion and application.
作者
龚慧
王杨
刘中波
于兵
孙海峰
曹政
GONG Hui;WANG Yang;LIU Zhong-bo;YU Bing;SUN Hai-feng;CAO Zheng(Department of Burn and Plastic Surgery,General Hospital of Northern Theater Command,Shenyang 110016,China)
出处
《中国美容整形外科杂志》
CAS
2021年第3期158-162,167,共6页
Chinese Journal of Aesthetic and Plastic Surgery
关键词
A型肉毒毒素
复方倍他米松
大面积增生性瘢痕
安全性
Botulinum toxin type A
Compound betamethasone
Large area of hypertrophic scar
Safety
