低浓度曲安奈德在美容手术和创伤后早期应用

Low concentration of triamcinolone acetonide applications in cosmetic surgery and early after trauma

目的在美容手术和创伤后早期应用低浓度曲安奈德进行注射治疗,观察研究低浓度曲安奈德对于创口瘢痕预防治疗的有效性和安全性。方法选取2012年1月到2014年1月于本院就治的美容手术及外伤愈合后患者168例,随机将其分为试验组和对照组,试验组根据创口面积的大小注射由2%利多卡因4ml+曲安奈德40mg配置的低浓度曲安奈德溶液10天1次,三次为一疗程,曲安奈德每次总用量不大于80mg,视创伤部位瘢痕的程度每次调整用药范围、深度及用药量;对照组只常规外用抑制疤痕药。观察创伤部位瘢痕体积、瘢痕挛缩程度、瘢痕的柔软度及颜色、瘢痕部位瘙痒程度、瘢痕部位疼痛程度的变化,治疗后随访1年,观察患者的瘢痕的复发情况及治疗后的不良反应。结果试验组痊愈56例,显效13例,有效10例;无效5例;总有效率为94.0%。对照组痊愈31例(36.9%,显效19例,有效16例;无效18例;总有效率为78.6%。实验组的痊愈率和总有效率明显高于对照组,差异有统计学意义(P<0.05)。试验组出现不良反应5例,2例皮肤萎缩,3例毛细血管扩张;对照组10例患者出现瘢痕挛缩,瘢痕处组织挛缩明显,且瘢痕恢复周期明显长于实验组。随访1年间,实验组出现8例复发,复发率为9.5%,对照组29例复发,复发率为34.5%,复发率远高于实验组。结论使用低浓度曲安奈德在创伤后早期进行干预对创伤瘢痕的预防及治疗具有一定的积极意义,且药物的副作用较低,有利于面部美容手术的恢复,临床上值得推广。

Objective To investigate the efficacy and safety of triamcinolone acetonide in the prevention and treatment of wound scar at the low concentration of triamcinolone acetonide in cosmetic surgery and early posttraumatic injection.Methods A total of168patients were randomly divided into experimental group and control group.According to the wound area,the experimental group was injected with2%lidocaine The total dosage of triamcinolone acetonide40mg once a day for10days was3times,and the total dosage of triamcinolone acetonide was not more than80mg,depending on the extent of scars of the traumatic site and the dosage of medication;Control group only routine topical scars medicine.The scar size,the degree of scar contracture,the softness and color of scars,the degree of itching and the degree of scar pain were observed.The follow-up period was1year.The recurrence of scar and the adverse reaction were observed.Results The experimental group recovered56cases,markedly effective in13cases,effective in10cases;ineffective in5cases;the total effective rate was94.0%.The cure rate and the total effective rate in the experimental group were significantly higher than those in the control group(P<0.05),and the difference was statistically significant(P<0.05).There were5cases of adverse reactions in the experimental group,2cases of skin atrophy,3cases of telangiectasia;control group of10patients with scar contracture scar tissue contracture,and scar recovery cycle was significantly longer than the experimental group.A follow-.The relapse rate was9.5%in the experimental group and29.5%in the control group.The recurrence rate was34.5%,and the recurrence rate was much higher than that in the experimental group.Conclusion The use of low concentration of triamcinolone acetonide in early posttraumatic intervention on the prevention and treatment of traumatic scar has a positive significance,and the side effects of drugs is low,is conducive to the recovery of facial cosmetic surgery,clinically worthy of promotion.