激素局部注射治疗儿童瘢痕的疗效分析

A Study on Hormone Local Injecting Treatment of Scar in Children

目的探讨肾上腺皮质激素醋酸曲安奈德局部注射对儿童增生性瘢痕、瘢痕疙瘩的治疗效果及预防瘢痕形成的疗效。方法对增生性瘢痕、瘢痕疙瘩及预防性注射治疗的患儿473例,共行1514次醋酸曲安奈德局部注射,观察临床效果并进行回顾性分析、评价和总结。结果增生性瘢痕治疗效果良好,有效率达100%,对关节部位瘢痕的挛缩有明显减轻和预防的作用。瘢痕疙瘩直接注射效果较差,手术切除术后,进行预防性注射可收到良好效果。其余手术后经预防性注射,无增生性瘢痕发生。注射期间28例出现早期Cushings综合征表现,停药半年后消失,随访5年以上,无生长发育异常。结论小剂量激素局部注射是治疗和预防儿童增生性瘢痕、瘢痕疙瘩的较为安全、可靠、有效的非手术治疗方式之一。

Objectives To investigate the clinical therapeutic and preventive efficacy on hypertrophic scar,keloid in children by using local injections with glucocorticoid (Triamcinolone acitonide acetate). Methods 487 children with hypertrophic scar and keloid were preventive injected locally with Triamcinolone acitonide acetate, altogether 1514 times were evaluated,analyzed retrospectively and summarized.These cases were from 3 months to 17 years old,average age 4 years old and 7 months. Results By local injecting treatment of hypertrophic scar had good efficacy,effective rate reached 100% obviously prevent or relieve scar contracture at elbow joint,but efficacy of local direct injection on keloid was poor, prevetive injection obviously improved the therapeutic effect after the keloid resectional therapy.28 cases appeared earlier Cushing,s syndrome during the treatment of injection.Withdrawal after half a year,the syndrome completely disappearance.Followed up for 5 years,no case occurred abnormal growth and development. Conclusions Local injection of small dose Triamcinolone acitonide acetate is an important nonoperation treatment and could prevent the hypertrophic scar and keloid,it is safe,reliable and efficient.