本文關(guān)鍵詞： 曲安奈德 透明質(zhì)酸酶 瘢痕疙瘩　出處：《青島大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

【摘要】：目的:研究聯(lián)合應(yīng)用透明質(zhì)酸酶和曲安奈德治療瘢痕疙瘩的療效及安全性,為瘢痕疙瘩探索一種安全、有效的臨床治療方法。方法:選擇2011年9月至2014年3月來濰坊市益都中心醫(yī)院美容科就診的瘢痕疙瘩患者96例為研究對(duì)象,隨機(jī)分為兩組,其中治療組48例,采用透明質(zhì)酸酶聯(lián)合曲安奈德注射治療,對(duì)照組48例,采用單純曲安奈德注射治療。采用溫哥華量表評(píng)分判定瘢痕疙瘩的嚴(yán)重程度,此量表采用色澤、厚度、血管分布和柔軟度四個(gè)指標(biāo)對(duì)瘢痕進(jìn)行描述性評(píng)估,并根據(jù)評(píng)分的高低將瘢痕疙瘩分為輕度、中度和重度。治療方法:治療組應(yīng)用曲安奈德注射液1ml(40mg)+2%利多卡因注射液和透明質(zhì)酸酶混合液2.5ml+2%利多卡因注射液0.5ml;對(duì)照組應(yīng)用曲安奈德注射液1ml(40mg)+2%利多卡因注射液3ml。用高壓注射器從瘢痕邊緣向內(nèi)分點(diǎn)穿刺,將藥液緩慢注入均勻瘢痕組織內(nèi),至局部組織蒼白為止,治療1~2周重復(fù)1次,4次為1個(gè)療程,一般1~2個(gè)療程。治療后3、6、12個(gè)月復(fù)診。觀察兩組患者治療前后臨床癥狀、疤痕顏色、疤痕厚度及瘢痕柔韌性,同時(shí)根據(jù)療效判斷標(biāo)準(zhǔn)評(píng)價(jià)兩種治療方法的治愈率、有效率及并發(fā)癥的發(fā)生率。結(jié)果:(1)兩組患者治療前一般資料比較:兩組患者年齡、性別構(gòu)成比、瘢痕面積、病程、發(fā)病部位及瘢痕原因等無明顯的統(tǒng)計(jì)學(xué)差異(均P0.05)。(2)兩組患者臨床療效比較:治療組46例患者,治愈28例,顯效16例,無效2例;對(duì)照組43例患者中,治愈18例,顯效21例,無效4例,經(jīng)秩和檢驗(yàn),治療組患者臨床療效顯著優(yōu)于對(duì)照組(P0.01)。(3)兩組患者治愈率和有效率比較:治療組患者的治愈率為60.9%(28/46),有效率為95.7%(44/46),對(duì)照組患者的治愈率為41.9%(18/43),有效率為90.7%(39/43),治療組患者的治愈率和有效率顯著高于對(duì)照組(均P0.05)。(4)兩組患者治療前后溫哥華量表評(píng)分比較:治療組和對(duì)照組患者治療前溫哥華量表評(píng)分分別為8.63±1.67和8.28±1.35,無明顯統(tǒng)計(jì)學(xué)差異(p0.05),治療后兩組患者溫哥華量表評(píng)分分別為4.89±1.14和6.35±1.08,均較治療前明顯下降(p0.01),但治療組下降更為明顯,治療組治療后的溫哥華評(píng)分顯著低于對(duì)照組(p0.05)。(5)兩組患者臨床癥狀改善情況比較:治療組、對(duì)照組患者治療前疼痛評(píng)分和瘙癢評(píng)分無明顯統(tǒng)計(jì)學(xué)差異(p0.05),治療后疼痛評(píng)分、瘙癢評(píng)分均明顯下降,與治療前比較,均有顯著統(tǒng)計(jì)學(xué)差異(均p0.01),但治療組下降更為明顯,治療組治療后的疼痛評(píng)分和瘙癢評(píng)分均顯著低于對(duì)照組(均p0.05)。(6)兩組治療方法副作用和復(fù)發(fā)情況比較:兩組在治療中各有2位女性患者出現(xiàn)經(jīng)期提前和月經(jīng)量增大現(xiàn)象,未行治療,于治療結(jié)束后兩月痊愈。對(duì)照組有1例患者出現(xiàn)局部皮膚發(fā)黑,但未破潰,一月后逐漸恢復(fù)。治療組1例無效,1例復(fù)發(fā);對(duì)照組1例無效,3例復(fù)發(fā)。結(jié)論:(1)透明質(zhì)酸酶聯(lián)合曲安奈德皮損內(nèi)注射治療瘢痕疙瘩有很好的療效,療效優(yōu)于單純曲安奈德皮損內(nèi)注射,且安全可靠,值得臨床廣泛應(yīng)用。(2)透明質(zhì)酸酶聯(lián)合曲安奈德皮損內(nèi)注射瘢痕疙瘩操作簡便,不需要大型設(shè)備,治療費(fèi)用低,療效可靠,便于基層醫(yī)院開展。
[Abstract]:Objective: To study the efficacy and safety of hyaluronidase and Cu Ann Ned treatment of keloid, explore a safe for keloid, effective clinical treatment. Methods: from September 2011 to March 2014 to Yidu Central Hospital of Weifang beauty hospital keloids patients 96 patients as the research object, randomly divided into two group, including 48 cases of treatment group with combined hyaluronidase Cu Ann Ned injection therapy, the control group of 48 cases, using a simple Cu Ann Ned injection. The Vancouver score in determining the severity of keloids, this scale by color, thickness, vascular distribution and softness of the four indicators for descriptive evaluation of scar, and the keloids were divided into scores according to the level of moderate and severe treatment. Methods: the treatment group used Triamcinolone Acetonide Injection 1ml (40mg) +2% lidocaine injection and hyaluronic acid The enzyme mixture 2.5ml+2% 0.5ml lidocaine injection; the control group used the Triamcinolone Acetonide Injection 1ml (40mg) +2% 3ml. lidocaine injection with high pressure injector puncture point from the scar edge inward, liquid will be slowly injected into the scar tissue in uniform, pale to local tissue until repeated 1 times, treatment 1~2 weeks, 4 times for 1 courses, general 1~2 courses. 3,6,12 months after treatment follow-up. Clinical symptoms, two groups of patients before and after treatment of scar scar thickness and scar color, flexibility, and according to the curative effect judgment the cure rate of two treatment methods for standard evaluation, the incidence of complications and efficiency. Results: (1) the general data of the two groups were compared: two groups of patients before treatment age, ratio, scar size, duration of gender, there is no significant difference between the incidence and causes of hypertrophic scar (P0.05). (2) comparison of two groups of patients with clinical curative effect: the treatment group of 46 cases, 娌繪剤28渚，

本文編號(hào)：1455623