小剂量^90锶贴敷联合复方肝素钠尿囊素凝胶在耳廓瘢痕疙瘩辅助治疗中的应用及随访研究

Application and follow-up study of low-dose^90 strontium patch combined with compound heparin sodium allantoin gel in adjuvant treatment of auricular keloids

目的分析小剂量90锶贴敷联合复方肝素钠尿囊素凝胶辅助治疗耳廓瘢痕疙瘩的效果。方法选取我院87例耳廓瘢痕疙瘩患者(2017年10月-2019年8月),依照随机数字表法将其分为两组。两组均接受CO2激光治疗,同时对照组(43例)接受复方肝素钠尿囊素凝胶辅助治疗,观察组(44例)在对照组基础上接受小剂量90锶贴敷辅助治疗,比较两组疗效,以及治疗前后瘢痕疙瘩变化情况(长度、宽度、厚度)、温哥华瘢痕量表(VSS)评分、成纤维细胞转化生长因子-β1(TGF-β1)、碱性成纤维细胞生长因子(bFGF)、血管内皮生长因子(VEGF)。结果两组治疗总有效率对比,观察组较对照组高(P<0.05);治疗后,两组瘢痕疙瘩均有所缩小,且观察组长度、宽度、厚度均低于对照组(P<0.05);治疗后,两组VSS评分均有所降低,且观察组低于对照组(P<0.05);治疗后,观察组TGF-β1、VEGF较对照组低,bFGF较对照组高(P<0.05)。结论小剂量90锶贴敷联合复方肝素钠尿囊素凝胶辅助治疗耳廓瘢痕疙瘩的临床效果显著,能有效促进瘢痕疙瘩消失、改善临床症状,且能调节相关因子表达。

Objective To analyze the effect of low-dose 90strontium patch combined with compound heparin sodium allantoin gel in adjuvant treatment of auricular keloids.Methods A total of 87 patients with auricular keloids in our hospital(from October 2017 to August 2019)were selected and divided into two groups according to the random number table method.Both groups received CO2 laser treatment,while the control group(43 cases)received adjuvant treatment with compound heparin sodium allantoin gel,and the observation group(44 cases)received a small dose of 90 strontium adjuvant treatment on the basis of the control group.The curative effect,as well as the changes of keloid(length,width,thickness),Vancouver Scar Scale(VSS)score,fbroblast transforming growth factor-β1(TGF-β1),basic fibroblast growth factor(bFGF),and vascular endothelial growth factor(VEGF)of the two groups before and after treatment were compared.Results The total effective rate of the two groups was compared,and the observation group was higher than that of the control group(P<0.05).After treatment,the keloids of the two groups were reduced,and the length,width and thickness of the observation group were lower than those of the control group(P<0.05).After treatment,the VSS scores of the two groups were reduced,and the observation group was lower than the control group(P<0.05).After treatment,TGF-β1 and VEGF in the observation group were lower than those in the control group,and bFGF was higher than that in the control group(P<0.05).Conclusion Lowdose 90 strontium patch combined with compound heparin sodium allantoin gel has a significant clinical effect in adjuvant treatment of auricular keloids,which can effectively promote the disappearance of keloids,improve clinical symptoms,and can regulate the expre s sion of related factors.