光动力疗法联合复方倍他米松局部封闭治疗增生性瘢痕疗效观察

摘要

目的:研究光动力疗法联合复方倍他米松注射液局部封闭治疗增生性瘢痕的临床疗效.方法:选取2014年1月-2016年1月笔者科室收治的增生性瘢痕患者72例,随机分为试验组和对照组,每组36例.试验组使用光动力法与复方倍他米松注射液进行联合治疗,对照组仅使用复方倍他米松注射液进行治疗.治疗后以临床总有效率、瘢痕评分、不良反应及复发率作为判定疗效指标.结果:患者性别、年龄、病程、皮损部位、瘢痕增生程度组间比较差异均无统计学意义(P>0.05),治疗后试验组总有效率88.9%,显著高于对照组的55.6% (P<0.05);与对照组比较,试验组患者治疗期间、治疗结束后2个月、治疗结束后1年的温哥华瘢痕评定量表、北卡罗来纳大学瘢痕量表评分均明显降低,差异具有统计学意义(均P<0.05);试验组患者复发率6.25%,明显低于对照组35.00% (P<0.05),且未增加不良反应的发生率(P>0.05).结论:光动力疗法联合复方倍他米松注射液局部封闭治疗增生性瘢痕疗效明显,可降低复发率,值得临床推广使用.%Objective To evaluate the clinical effect of the combination of the local block therapy of hypertrophic scar with photodynamic therapy and compound betamethasone injection. Methods 72 patients with hypertrophic scar in our hospital from January 2014 to January 2016 were randomly divided into control group or experimental group,36 case in each group.Patients in experimental group were treated with photodynamic therapy and compound betamethasone injection,patients in control group only accepted compound betamethasone injection.The clinical total effective rates,scar scale,adverse events and recurrence rate were compared between two groups. Results The total efficiency rate of experimental group was significantly higher than that of control group (88.9% vs 55.6%, P<0.05). Compared with the control group, the value of Vancouver scar rating scale and the university of north Carolina scar scale were significantly decreased in experimental group after treatment for 4, 6, 12 months respectively (allP<0.05).The rate of recurrence was smaller in experimental group than that of control group (P<0.05),however,there was no statistically significant difference on adverse events between two groups (P>0.05). Conclusion Photodynamic therapy combined with compound betamethasone injection for the local block treatment of hypertrophic scar has a significant clinical effect, and reduces the risk of recurrence.It is worth of widely clinical use.