低浓度丝裂霉素C及曲安奈德治疗瘢痕疙瘩应用观察.doc

低浓度丝裂霉素C及曲安奈德治疗瘢痕疙瘩应用观察【摘要】 目的 观察低浓度丝裂霉素C与糖皮质激素联合局部注射治疗瘢痕疙瘩的疗效及安全性。方法 研究分两组,单纯激素治疗组48例瘢痕疙瘩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例瘢痕疙瘩患者将0.04 mg丝裂霉素C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,丝裂霉素C联合糖皮质激素治疗瘢痕疙瘩的总有效率为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 低浓度丝裂霉素C与糖皮质激素联合局部注射治疗瘢痕疙瘩的疗效显著。 【关键词】瘢痕疙瘩;丝裂霉素C;糖皮质激素 The therapy function of low concentration mitomycin C associate with steroid to keloid WANG Xu dong.Department of Burn and Plastic Surgery ,ZaZhuang Municipal Hospital,Shandong 277102,China 【Abstract】 Objective To monitor the therapeutic action and security of mitomycin C associate with steroid injected to keloid.Methods 48 patients were treated merely with corticosteroid injection to keloid,once in 2weeks.The other 42 patients around sternal area were treated with intralesional injection of a mixture of 0.04 mg mitomycin C,5 ml corticosteroid and 1 ml 2%lidocaine once per 2 4 weeks.After keloid r became flattened,drug concentration was decreased with prolonged intermission of drug injection.Results The total therapy efficacy of mitomycin C associate with steroid to keloid was 97.62%.the complete remission percentage was 45.23%,the large remission percentage was 47.62%,part remission percentage was 4.72%,and the inefficacy percentage was 2.38%.Conclusion It is more effective that the combination therapy to keloid of low concentration mitomycin C and steroid. 【Key words】Keloid;Mitomycin C;Steroid 瘢痕疙瘩(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。我们采用了低浓度丝裂霉素C 0.01 mg/ml,以针对性地抑制瘢痕疙瘩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例瘢痕疙瘩,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2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;在我科的治疗时间为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在治疗期内均直接瘢痕内低浓度丝裂霉素C与糖皮质激素混合注射:将0.04 mg丝裂霉素C(日本Kyowa Hakko Kogyo Co.,Ltd.Fuji Plant)、2%利多