低浓度5-氟尿嘧啶联合糖皮质激素在增生性瘢痕应用观察.docVIP

低浓度5-氟尿嘧啶联合糖皮质激素在增生性瘢痕的应用观察 　　【摘要】目的观察低浓度5?氟尿嘧啶与糖皮质激素联合局部注射治疗增生性瘢痕的疗效及安全性。方法研究分两组,单纯激素治疗组48例增生性瘢痕患者进行单纯曲安奈德注射瘢痕内注射,1次/2周。联合治疗组42例增生性瘢痕患者将0.6 ml 5?FU与5 ml曲安奈德、1 ml 2%利多卡因混合后局部注射于瘢痕全层,1次/2~4周。瘢痕完全萎缩后逐渐降低药物浓度并延长注射间歇期。结果在治疗6个月以上的患者中,5?氟尿嘧啶联合糖皮质激素治疗增生性瘢痕的总有效率为97.62%,其中完全缓解者占45.23%,极大缓解者占47.62%,部分缓解者占4.72%,未缓解者为2.38%。 结论低浓度5?氟尿嘧啶与糖皮质激素联合局部注射治疗增生性瘢痕的疗效显著。? 　　【关键词】 　　增生性瘢痕;5-氟尿嘧啶;糖皮质激素 　　?? 　　 　　The therapy function oflow concentration 5?Fu associate with steroid to hypertrophic scar 　　 　　WANG Xu?dong.Burn and Plastic Surgery Department,ZaZhuang Municipal Hospital,Shandong 277102,China 　　? 　　【Abstract】ObjectiveTo monitor the therapeutic action and security of 5?FU associate with steroid injected to hypertrophic scar.Methods48 patients was treated merely with corticosteroid injection to hypertrophic scar,once/2weeks.The other 42 patients around sternal area were treated with intralesional injection of a mixture of 0.6 ml 5?FU,5 ml corticosteroid and 1 ml 2% lidocaine once per 2?4 weeks.After hypertrophic scar became flattened,drug concentration was decreased with prolonged intermission of drug injection.ResultsThe total therapy efficacy of 5?FU associate with steroid to hypertrophic scar is 97.62%.Of them the complete remission percentage is 45.23%,the large remission percentage is 47.62%,part remission percentage is 4.72%,and the inefficacy percentage is 2.38%.ConclusionIt is more effective that the combination therapy to hypertrophic scar oflow concentration 5?FU and steroid.? 　　【Key words】 　　Hhypertrophic scar;5?FU;Steroid 　　? 　　增生性瘢痕(hypertrophic scar,HS)是皮肤损伤愈合过程中,胶原合成代谢机能失去正常的约束控制,以至胶原纤维过度增生的结果。针对病因及不同的病程阶段,通常采用手术和非手术治疗的方法,但往往易复发。我们采用了低浓度5?氟尿嘧啶(5?FU)2~4 mg/ml,以针对性地抑制增???性瘢痕形成及复发过程中的血管增生和营养供应??[1]?,并联合皮质类固醇治疗90例增生性瘢痕,获得了满意疗效。? 　　 　　1临床资料? 　　 　　1.1病例来源本组90例患者,其中男42例,女48例,年龄14~71岁,平均38岁;平均瘢痕增生时间6.6年。这些患者被随机分为两组,分别接受联合治疗或单纯激素治疗。约60%为接受过各种治疗后复发或无法控制者;在本科的治疗时间为6~10个月,平均治疗时间为8.29个月。? 　　1.2诊断标准有或无治疗史;瘢痕持续生长;有刺痛和/或瘙痒症状;质韧或硬。? 　　1.3治疗方法? 　　1.3.1治疗期联合治疗组所有患者