增生性瘢痕形成的病理机制和当代治疗现状

Progress of pathogenesis and therapy of hypertrophic scar

增生性瘢痕(HS)是机体在创伤后发生过度异常修复的结果,机体创伤后的愈合过程中,免疫细胞释放的炎性因子可刺激组织细胞过量分泌转化生长因子-β、血小板衍生生长因子和胰岛素样生长因子等,从而增强成纤维细胞活性,促进瘢痕内血管形成。同时,上皮干细胞也在炎性因子刺激下不断增殖并刺激成纤维细胞使其保持细胞增殖活性而过量增生,间充质细胞同时参与了上皮干细胞与成纤维细胞增殖的过程。对于增生性瘢痕,当代治疗手段主要以手术切除附以放射治疗为主,其他治疗方法还有加压、冷冻、中医药及基因治疗等,具体治疗手段仍以患者个例的情况制定相应的治疗措施。

Hypertrophic scar（HS）, which results from excessively abnormal wound healing, can cause deformities, dyskinesia and paresthesia in patients. Surgical incision is preferred treatment fnr HS, hut the high postoperative recurrence greatly bothers patients and surgeons. The pathogenesis of HS includes four novel perspectives, including its promoter, inflammatory mediators, epithelial stem cells and physical environment of the wound. The methods of trealment for HS inclmte operation incision, radiology, pressure, hypothemia and chinese medicine.