弹力压迫硅胶喷剂外用联合曲安奈德注射治疗烧伤后瘢痕增生的效果观察

Effect of Elastic Compression Plus Silicone Spray Combined with Triamcinolone Acetonide Injection on Scar Hyperplasia after Burn

目的:探讨弹力压迫、硅胶喷剂联合曲安奈德治疗烧伤后瘢痕增生的临床效果。方法:选取笔者医院2016年1月-2017年6月收治的140例(468个烧伤部位)烧伤患者,采用随机数字表法分为联合组和对照组,各234个部位。联合组采用弹力压迫硅胶喷剂联合曲安奈德注射治疗,对照组仅给予弹力压迫硅胶喷剂治疗。对比两组患者治疗前、后的瘢痕组织厚度、瘢痕组织中Ⅰ型、Ⅲ型胶原纤维含量、临床效果及患者简明烧伤健康量表(BSHS-2A)评分的变化。结果:治疗前,联合组和对照组的瘢痕组织厚度、瘢痕组织中Ⅰ型、Ⅲ型胶原纤维含量比较,差异不具有统计学意义(P>0.05);治疗后,联合组的瘢痕组织厚度、瘢痕组织中Ⅰ型胶原纤维均低于对照组,Ⅲ型胶原纤维含量高于对照组,差异有统计学意义(P<0.05);联合组患者的瘢痕防治效果显著优于对照组,差异有统计学意义(P<0.05)。治疗后,联合组的健康状况、躯体功能、心理功能、总分均高于对照组,差异有统计学意义(P<0.05)。结论:弹力压迫、硅胶喷剂联合曲安奈德治疗烧伤后瘢痕增生效果显著、能调节瘢痕组织中的Ⅰ型、Ⅲ型胶原纤维含量水平,利于患者生存质量的改善。

Objective To investigate the clinical effect of elastic compression silicone combined with triamcinolone acetonide injection on scar hyperplasia after burn.Methods 140 patients(468 burn sites)admitted to our hospital from January 2016 to June 2017 were randomly divided into the combined group and the control group,234 sites in each group.The combined group was treated with elastic compression silicone spray combined with triamcinolone acetonide injection,and the control group was only treated with elastic compression silicone spray;The thickness of scar tissue before and after treatment,the typeⅠand typeⅢcollagen fibers in scar tissue,the clinical effect and the patient's concise burn health scale(BSHS-2A)score were compared.Results Before treatment,the thickness of scar tissue and the content of typeⅠand typeⅢcollagen fibers in the scar tissue of the combined group and the control group were not statistically significant(P>0.05).After treatment,the thickness of scar tissue and typeⅠcollagen fibers in the scar tissue were lower than those in the control group,and the content of typeⅢcollagen fibers was higher than that in the control group,the differences were statistically significant(P<0.05).The effect of scar prevention in the combined group was significantly better than that in the control group(P<0.05).After treatment,the health status,physical function,psychological function and total score of the combined group were higher than those of the control group(P<0.05).Conclusion Elastic compression of silica combined with triamcinolone acetonide for the treatment of scar hyperplasia after burns,can regulate the level of typeⅠand typeⅢcollagen fibers in scar tissue,which is conducive to the improvement of patients'quality of life.