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早期和静止期病理性瘢痕内注射曲安奈德的疗效比较。

Comparative efficacy of intralesional triamcinolone acetonide injection during early and static stage of pathological scarring.

机构信息

State Key Laboratory of Trauma, Burns, and Combined Injury, Institute of Burn Research, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China.

出版信息

J Cosmet Dermatol. 2019 Jun;18(3):874-878. doi: 10.1111/jocd.12690. Epub 2018 Jun 22.

Abstract

OBJECTIVE

This study aims to clarify whether the effect of intralesional triamcinolone acetonide injection during the early stage of scarring differs from the static stage, which still remains unclear.

METHODS

A total of 108 patients with pathological scars were enrolled in this study and were divided into 2 groups according to the time of first treatment after injury: the early stage group(≤6 months after injury) and the static stage group(>6 months after injury). Patients of both groups were then treated with intralesional triamcinolone acetonide injection. The Vancouver scar scale was adopted for the evaluation of scars, and a durometer was utilized for the measurement of the hardness of the scar. The visual analog scale was adopted for the assessment of patients' subjective feelings (pruritus and pain). In the meantime, adverse drug reactions were also recorded.

RESULTS

After intralesional injection of triamcinolone acetonide, most of the hypertrophic scars and keloids improved in color, thickness, softness, and vascular distribution. The hardness of scars improved significantly. The overall efficacy of the static stage group was superior to the early stage group. Most patients, after the injection of triamcinolone acetonide, had significant alleviation or even total loss of cicatricial pain and pruritus.

CONCLUSIONS

This study demonstrates that the treatment efficacy was better when applied during the static stage of pathological scarring rather than the early stage, which might be due to macrophages and their released cytokines. This study provides new clinical evidence for optimizing drug therapy of pathological scars.

摘要

目的

本研究旨在阐明增生性瘢痕和瘢痕疙瘩在早期阶段与静止期阶段接受病灶内曲安奈德注射治疗的效果是否存在差异,目前这方面的研究仍不明确。

方法

共纳入 108 例病理性瘢痕患者,根据受伤后首次治疗的时间分为早期组(≤6 个月)和静止期组(>6 个月)。两组患者均接受病灶内曲安奈德注射治疗,采用温哥华瘢痕量表评估瘢痕,硬度计测量瘢痕硬度,视觉模拟评分法评估患者的主观感受(瘙痒和疼痛),同时记录药物不良反应。

结果

病灶内注射曲安奈德后,大部分增生性瘢痕和瘢痕疙瘩的颜色、厚度、质地和血管分布均有改善,瘢痕硬度明显改善,静止期组的总体疗效优于早期组。大部分患者注射曲安奈德后,瘢痕痛和瘙痒明显减轻甚至完全消失。

结论

本研究表明,病理性瘢痕的静止期阶段接受治疗的效果优于早期阶段,这可能与巨噬细胞及其释放的细胞因子有关。本研究为优化病理性瘢痕的药物治疗提供了新的临床证据。

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