重组人血管内皮抑制素联合CO2点阵激光治疗瘢痕疙瘩的临床疗效观察

Clinical efficacy of recombinant human endostatin combined with CO2 lattice laser in the treatment of keloid

目的:探讨重组人血管内皮抑制素治疗瘢痕疙瘩的临床疗效。方法:选取2017年10月-2018年6月在南充市中心医院就诊的瘢痕疙瘩患者80例,随机分为观察组和对照组,观察组和对照组两组患者均进行二氧化碳点阵激光治疗。对照组给予曲安奈德瘢痕内注射治疗,观察组给予重组人血管内皮抑制素注射治疗。记录两组患者治疗前后瘢痕面积、严重程度评分,不良反应以及治疗后3个月、6个月的复发情况。根据患者自觉症状、瘢痕的生长速度和厚度确定最终治疗疗效标准。结果:观察组治疗后瘢痕面积较治疗前减少(4.5±0.3)cm^2,对照组瘢痕面积较治疗前减少(3.2±0.5)cm^2,二者比较有统计学意义(P<0.05);观察组和对照组治疗后严重程度评分比较[(3.6±1.2)vs(5.1±1.9)]差异有统计学意义(P<0.05);观察组和对照组治疗后不良反应发生率对比(5%vs 15%)有明显统计学差异(P<0.05);二者在治疗3个月后复发率相似,比较无统计学差异(P>0.05);治疗后6个月复发率,观察组(5%)与对照组(20%)相比有明显统计学差异(P<0.05)。观察组40例患者中治愈31例,显效9例,无效0例;对照组中治愈18例,显效21例,无效1例;二者比较P<0.05,有统计学意义。结论:重组人血管内皮抑制素治疗瘢痕疙瘩的疗效要明显优于传统类固醇药物曲安奈德,且治疗过程中副反应及6个月后复发率也较类固醇药物低。

Objective:To investigate the clinical efficacy of recombinant human endostatin for the treatment of keloid.Methods:80 patients with keloid in Nanchong central hospital from October 2017 to June 2018 were randomly divided into the observation group and the control group.The patients in both groups were all treated with carbon dioxide lattice laser.At the same time,the control group was treated with intra-scar injection of triamcinolone acetonide while the observation group was treated with recombinant human endostatin.Scar area,severity score,adverse reactions before and after treatment and the recurrence rate at the 3 rd month and the 6 th month after treatment were recorded.The criteria of finally curative effect were determined according to the patient’s conscious symptoms,the growth rate and thickness of scar.Results:The scar area of the observation group and the control group decreased by(4.5±0.3)cm^2 and(3.2±0.5)cm^2 respectively after treatment,and there were significant differences between them(P<0.05).The severity score and the incidence of adverse reactions in the observation group were significantly lower than those in the control group(3.6±1.2 vs 5.1±1.9;5%vs 15%,P<0.05).The recurrence rate at 3 rd month of the two groups was similar(P>0.05)while the recurrence rate of the observation group at 6 th month were significantly lower than that of the control group(5%vs 20%,P<0.05).In the observation group,31 cases were cured,9 cases were markedly effective and 0 case was ineffective.And in the control group,18 cases were cured,21 cases were markedly effective and 1 case was ineffective.There were significant differences between them(P<0.05).Conclusion:The efficacy of recombinant human endostatin for keloid was better than that of traditional steroid(triamcinolone acetonide).And the side effects and recurrence rate at 6 th months of recombinant human endostatin were lower than those of steroids.Recombinant human endostatin is expected to replace steroids in the treatment of keloids.