光动力疗法联合糖皮质激素治疗瘢痕疙瘩疗效观察

Effect of photodynamic therapy combined with glucocorticoid in the treatment of keloid

目的探讨光动力疗法联合糖皮质激素治疗瘢痕疙瘩的临床效果。方法选择2017年1月至2019年1月新乡医学院第一附属医院收治的86例瘢痕疙瘩患者为研究对象,根据治疗方法将患者分为观察组和对照组,每组43例。对照组患者给予复方倍他米松注射液皮损内注射治疗,观察组患者给予光动力疗法联合复方倍他米松注射液皮损内注射;治疗2个月后评估临床疗效,并观察治疗期间患者不良反应;分别于治疗前、治疗1个疗程、治疗后2个月、治疗后1 a对2组患者瘢痕情况进行温哥华瘢痕量表(VSS)评分和北卡罗来纳大学瘢痕量表评分。结果观察组和对照组患者治疗总有效率分别为88.37%(38/43)、55.81%(24/43),观察组患者治疗总有效率显著高于对照组(χ2=11.328,P<0.05)。观察组和对照组患者不良反应发生率分别为20.93%(9/43)、25.58%(11/43),2组患者不良反应发生率比较差异无统计学意义(χ2=0.261,P>0.05)。治疗前2组患者VSS评分、北卡罗来纳大学瘢痕量表评分比较差异无统计学意义(P>0.05),2组患者治疗1个疗程、治疗后2个月及治疗后1 a时VSS评分、北卡罗来纳大学瘢痕量表评分显著低于治疗前(P<0.05);治疗1个疗程、治疗后2个月及治疗后1 a时,观察组患者VSS评分、北卡罗来纳大学瘢痕量表评分显著低于对照组(P<0.05)。结论光动力疗法联合糖皮质激素皮损内注射能够显著改善瘢痕疙瘩状态,提高临床疗效,且无明显不良反应。

Objective To investigate the clinical effect of photodynamic therapy combined with glucocorticoid in the treatment of keloid.Methods A total of 86 patients with keloid admitted to the First Affiliated Hospital of Xinxiang Medical University from January 2017 to January 2019 were selected as the research subjects,and they were divided into observation group and control group according to the treatment methods,with 43 cases in each group.The patients in the control group were treated with compound betamethasone injection by subcutaneous injection,and the patients in the observation group were treated with photodynamic therapy and compound betamethasone injection by subcutaneous injection.The clinical effect was evaluated after two months of treatment,and the adverse reactions during treatment were observed.The scar condition of the patients in the two groups were evaluated by Vancouver scar scale(VSS)and University of North Carolina scar scale at the time points of before treatment,one course of treatment,two months after treatment and one year after treatment.Results The total effective rate in the observation group and the control group was 88.37%(38/43)and 55.81%(24/43),respectively.The total effective rate in the observation group was significantly higher than that in the control group(χ2=11.328,P<0.05).The incidence of adverse reactions in the observation group and the control group was 20.93%(9/43)and 25.58%(11/43),respectively.There was no significant difference in the incidence of adverse reactions between the two groups(χ2=0.261,P>0.05).There was no significant difference in the VSS score and the North Carolina University scar scale score between the two groups before treatment(P>0.05).The scores of VSS and University of North Carolina scar scale at the time points of before treatment,one course of treatment,two months after treatment and one year after treatment were significantly lower than those before treatment in the two groups(P<0.05).The scores of VSS and University of North Carolina scar scale in the observation group were significantly lower than those in the control group at the time points of one course of treatment,two months after treatment and one year after treatment(P<0.05).Conclusion Photodynamic therapy combined with glucocorticoid cutaneous intralesional injection can significantly improve the status of keloid,and increase the clinical effect without obvious adverse reactions.