手术切除联合博来霉素注射治疗耳廓瘢痕疙瘩的临床效果及对VSS评分、复发率的影响

Clinical effect of surgical excision combined with bleomycin injection in the treatment of auricular keloid and its influences on VSS score and recurrence rate

目的探讨手术切除联合博来霉素注射治疗耳廓瘢痕疙瘩的临床效果及对温哥华瘢痕量表(VSS)评分、复发率的影响。方法选取我院收治的56例耳郭瘢痕疙瘩患者作为研究对象,依据入院编号的奇偶性将其分为对照组(28例,手术切除+复方倍他米松)和观察组(28例,手术切除+博来霉素)。比较两组的临床治疗效果。结果观察组的临床治疗总有效率显著高于对照组(P<0.05)。术后12周,观察组的血管内皮生长因子(VEGF)、表皮细胞生长因子(EGF)、转化生长因子-β_(1)(TGF-β_(1))水平显著低于对照组(P<0.05)。术后2、4、12、24周,观察组的VSS、十二项目瘙痒量表(12-PSS)评分均显著低于对照组(P<0.05)。观察组的不良反应总发生率及复发率均显著低于对照组(P<0.05)。结论手术切除联合博来霉素注射治疗耳廓瘢痕疙瘩的临床效果显著,可改善瘢痕情况,降低复发率。

Objective To investigate the clinical effect of surgical excision combined with bleomycin injection in the treatment of auricular keloid and its influences on Vancouver Scar Scale(VSS)score and recurrence rate.Methods A total of 56 patients with auricular keloid admitted in our hospital were selected as the research objects,and the patients were divided into control group(28 cases,surgical excision+compound betamethasone)and observation group(28 cases,surgical excision+bleomycin)according to the parity of admission number.The clinical therapeutic effects of the two groups were compared.Results The total effective rate of clinical treatment in the observation group was significantly higher than that in the control group(P<0.05).At 12 weeks after operation,vascular endothelial growth factor(VEGF),epidermal growth factor(EGF)and transforming growth factor-β_(1)(TGF-β_(1))levels in the observation group were significantly lower than those in the control group(P<0.05).At 2,4,12 and 24 weeks after operation,the scores of VSS and 12-Item Pruritus Severity Scale(12-PSS)in the observation group were significantly lower than those in the control group(P<0.05).The total incidence of adverse reactions and recurrence rate in the observation group were significantly lower than those in the control group(P<0.05).Conclusion Surgical excision combined with bleomycin injection in the treatment of auricular keloid has a significant clinical effect,it can improve the scar condition and reduce the recurrence rate.