A型肉毒毒素对面部伤口愈合及减少瘢痕形成的Meta分析

Botulinum toxin type A injections in the facial plastic surgery incision:a meta-analysis

目的评估术后行A型肉毒毒素(BTXA)注射对切口愈合的影响。方法计算机检索1998年1月至2019年10月PubMed、EMbase、Cochrane Central、CNKI、VIP等数据库,检索词为面部创伤、瘢痕、增生性瘢痕、肉毒毒素、肉毒毒素A。纳入术后行BTXA注射与行安慰剂注射的随机对照试验文献7篇,采用RevMan 5.3软件进行Meta分析。结果共纳入7个随机对照试验450例患者。BTXA组温哥华瘢痕量表评分高于对照组(Z=23.92,P<0.01),BTXA组视觉模拟量表得分高于对照组(Z=8.60,P<0.01),BTXA组的瘢痕宽度小于对照组(Z=10.84,P<0.01),BTXA组患者满意度高于对照组(Z=2.83,P<0.01)。结论BTXA注射促进面部伤口愈合,对减少瘢痕形成有一定效果,但效果确切性和稳定性需更多高质量的随机对照试验证实。

Objective To systematically evaluate the influence of botulinum toxin type A(BTXA)injections in the facial plastic surgery incision.Methods A systematic literature search for studies which were published on PubMed,EMbase,Cochrane Central,CNKI and VIP,was performed from January 1998 to Octomber 2019."Facial wound","Keloid","Scar","Cicatrix hypertrophy","Botulinum toxin","Boutulin","Botox"were set as the key words.We included trails related to the influence of botulinum toxin type A(BTXA)injections in the facial plastic surgery incision.The data were extracted and Rev Man 5.3 was used for meta-analysis.Results Participants included seven randomized controlled trial of 450 patients.The Vancouver scar scale score of BTXA group was higher than those in the control group(Z=23.92,P<0.01).The visual analogue scale score of BTXA group was higher than that of the control group(Z=8.60,P<0.01).The scar width of BTXA group was less than that in the control group(Z=10.84,P<0.01).Patients'satisfactory rate of BTXA group was higher than that of the control group(Z=2.83,P<0.01).Conclusions The injection treatment of BTXA for facial hyperplastic scar has certain curative effect,without obvious side effects,but the authenticity and stability of therapeutic effect have to be verified by more high quality research.