胰岛素样生长因子对自体脂肪注射填充面部瘢痕的恢复作用

Effects of insulin-like growth factor on recovery of facial scar by autologous fat injection

目的探究胰岛素样生长因子对自体脂肪注射填充面部瘢痕的恢复作用。方法选取2017年8月至2018年8月接受自体脂肪注射填充面部瘢痕修复患者80例,随机分为2组,每组40例。对照组患者使用自体脂肪注射填充面部瘢痕,观察组患者在对照组患者的基础上,在自体脂肪脂肪中添加胰岛素样生长因子(IGF)。观察2组患者面部形态及面部两侧的对称性评分,2组患者不同时间创口愈合率,创面愈合时间以及愈合后瘢痕大小,出现并发症的概率及炎性因子的变化,利用疼痛视觉模拟评分(VAS)、温哥华瘢痕量表(VSS)、患者和观察者瘢痕评估量表(POSAS)、曼彻斯特瘢痕评定量表(MAPS)评价患者瘢痕恢复情况,同时在随访结束后调查2组患者对治疗的满意度。结果填充面部瘢痕1个月、3个月,2组患者面部形态及对称性优良比例显著升高,并且观察组患者高于对照组(P<0.05);随时间的增加,创面愈合率逐渐增加,观察组患者愈合率明显高于对照组(P<0.05);治疗后,观察组患者创面愈合时间比对照组短,创面体积较小(P<0.05);填充面部瘢痕后,观察组患者并发症发生概率显著低于对照组患者(P<0.05);治疗后肿瘤坏死因子(TNF-α)、白介素-6(IL-6)、白介素-8(IL-8)和γ干扰素(INF-γ)水平出现降低的趋势,且观察组比对照组降低明显(P<0.05)。经治疗后,观察组患者满意度(97.50%)明显高于对照组(82.50%)(P<0.05)。结论IGF可以显著提高自体脂肪注射填充面部瘢痕的效果,安全有效,深受患者的喜爱,值得在临床推广使用。

Objective To investigate the effects of insulin-like growth factor(IGF)on the recovery of facial scar by autologous fat injection.Methods A total of 80 patients with facial scar who were treated by by autologous fat injectionin our hospital from August 2017 to August 2018 wee enrolled in the study,who were randomly divided into control group and observation group,with 40 patients in each group.The patients in control group were treated by autologous fat injection,however,the patients in observation group,on the basis of control group,were treated by adding insulin-like growth factor(IGF)into autogenous fat.The facial morphology and symmetry score of both sides of the face,and the wound healing rate,wound healing time,scar size after healing,the incidence rate of complications and the changes of inflammatory factors at different time points of wound healing were observed and compared between the two groups.Moreover the recovery status of facial scar of patients and the changes of inflammatory factors were evaluated by Visua Analogue Scale(VAS),Vancouver scar scale(VSS),Observer Scar Assessment Scale(POSAS)and the Manchester scar rating scale(MAPS).In addition the satisfaction degree of patients for the treatment was investigated at the end of follow-up.Results After 1m and 3m after facial scar filling,the facial morphous and symmetry in both groups were improved significantly,moreover,which in observation group were superior to those in control group(P<0.05).The healing rate in observation group was significantly higher than that in control group(P<0.05).After treatment,the wound healing time in observation group was significantly shorter than that in control group,and the wound volume was significantly smaller than that in control group(P<0.05).After facial scar filling,the incidence rate of complications in observation group was significantly lower than that in control group(P<0.05).Moreover the levels of tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),interleukin-8(IL-8)and interferon-γ(INF-γ)in observation group were significantly lower than those in control group(P<0.05),and the satisfaction degree of patients in observation group(97.50%)was significantly higher than that(82.50%)in control group(P<0.05).Conclusion IGF can significantly improve the effects of autogenous fat injection for facial scar filling,with better safety and effectiveness,therefor,it is worth using and popularizing in clinical practice.