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瘢痕,肥大性

瘢痕,肥大性的相关文献在2001年到2021年内共计107篇,主要集中在外科学、基础医学、药学 等领域,其中期刊论文107篇、专利文献436693篇;相关期刊24种,包括中华临床医师杂志(电子版)、中华理疗杂志、中华创伤杂志等; 瘢痕,肥大性的相关文献由369位作者贡献,包括李世荣、陈璧、徐明达等。

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瘢痕,肥大性

-研究学者

  • 李世荣
  • 陈璧
  • 徐明达
  • 李荟元
  • 胡大海
  • 郭树忠
  • 刘剑毅
  • 刘宏亮
  • 吴宗耀
  • 姚庆君
  • 期刊论文
  • 专利文献

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    • 张黎黎; 刘文辉; 刘小静; 张琪; 丁岩; 刘林嶓
    • 摘要: 目的 探讨局部曲安奈德注射联合CO2点阵激光治疗增生性瘢痕的效果.方法 2019年3月至2020年5月,郑州大学第一附属医院整形外科就诊的增生性瘢痕患者80例,男45例,女35例,年龄18~42岁,平均28.1岁;分为试验组和对照组各40例.试验组先局部注射曲安奈德,再用CO2点阵激光治疗;对照组仅局部注射曲安奈德.治疗结束后由第三方盲评、温哥华瘢痕量表评分、视觉评分量表、皮肤病生活治疗指标调查表评估治疗结果.结果 治疗后,试验组治愈比例高于对照组(82.5%比52.5%,x2=8.216,P<0.05),治疗前两组温哥华瘢痕量表评分、视觉模拟评分、皮肤病生活治疗指标调查表评分差异均无统计学意义,治疗结束后试验组各项指标改善优于对照组(均P<0.05).结论 局部曲安奈德注射与CO2点阵激光治疗增生性瘢痕疗效确切,值得在临床应用.
    • 罗涵; 祁放; 王达利
    • 摘要: 增生性瘢痕(HS)存在疼痛、瘙痒、畸形及功能障碍等问题,严重影响人们的心理健康、降低生活质量.目前关于HS的治疗方案种类繁多,但疗效不尽理想.近年来,间充质基质细胞来源的外泌体(MSCs-Exo)在瘢痕防治中展现出治疗潜力,相关疗法的研究和开发正广泛开展.该文介绍了HS发病的病理基础和分子机制,并对脂肪、骨髓、脐带、脐血、羊膜、羊水等的MSCs-Exo在HS防治中的作用机制及研究进展进行综述,以期为HS的防治和新疗法的开发提供新的视角和思路.
    • 董岩; 戴骊颖; 雷旭光
    • 摘要: 目的 探讨脉冲染料激光联合曲安奈德治疗甲状腺术后增生性瘢痕的疗效.方法 2016年8月至2017年10月,将威海市立医院皮肤医疗美容科甲状腺术后增生性瘢痕患者76例(男22例,女54例,年龄18~48岁,平均31岁)分为两组.观察组38例采用595 nm脉冲染料激光联合曲安奈德注射液局部注射;对照组38例仅局部注射曲安奈德.每4周1次,未痊愈及复发者继续治疗,共治疗5次判断疗效和不良反应,随访12个月.结果 治疗后观察组治愈21例,占55.26%;有效32例,占84.21%;对照组治愈4例,占10.53%,有效16例,占42.11%,观察组治愈率及有效率均高于对照组(x 2=5.371,4.989,P<0.01).结论 595 nm脉冲染料激光联合局部注射曲安奈德治疗甲状腺术后增生性瘢痕见效快,不良反应小,疗效确切.
    • 於正福; 沈卫民; 崔杰; 陈建兵; 韩涛; 严俊; 邹继军
    • 摘要: 目的 探讨应用连续Z形皮瓣联合瘢痕减容矫正儿童手部增生性瘢痕挛缩畸形的效果.方法 2016年1月至2018年12月,南京医科大学附属儿童医院烧伤整形科共收治27例手部烧、烫伤后瘢痕挛缩畸形患儿,共累及36个关节部位,男12例,女15例,年龄10个月至12.5岁,平均2.8岁.首先根据掌指关节或指间关节挛缩程度将其分为轻、中、重度,以此制定治疗方案.对轻、中度畸形,设计连续Z形皮瓣松解挛缩畸形,瘢痕减容后转移皮瓣关闭创面;对重度畸形,在连续Z形皮瓣彻底松解、瘢痕减容后转移皮瓣覆盖创面,残余创面行游离植皮.术后对患儿手部功能和外观进行随访观察.结果 27例患儿手部36个关节部位中,轻度畸形12个,中度15个,重度9个,轻、中度畸形均未予游离植皮,重度畸形选择性地减少了植皮量,所有挛缩关节畸形均得到完全矫正.术后随访0.8~2.0年,均未再出现挛缩畸形,轻、中度患儿手部关节功能正常,皮瓣颜色、质地接近周围正常皮肤;重度患儿仅植皮部位有少量色素沉着.l例12.5岁的患儿因存活皮片弹性差、紧张感明显,在2年后再次行手术松解治疗,术后手指紧张感消失,效果满意.结论 连续Z形皮瓣联合瘢痕减容可最大程度地保留瘢痕表面的皮肤,减少植量皮,为儿童手部增生性瘢痕挛缩畸形提供了一种较好的治疗方法,术后远期效果稳定.
    • 易佳荣; 张红莲; 陈佳; 瞿思维; 欧阳华伟; 尹朝奇; 贺斌; 陶克; 周建大
    • 摘要: 瘢痕的预防与治疗一直都是创伤修复领域的重要任务.人类很早之前便开始针对瘢痕开展治疗,开创了一系列的传统治疗方法.同时随着科学技术的发展,国内外对于瘢痕的诊断治疗已经取得长足进步,通过机制研究开发出新的治疗药物和不断开创新的治疗方法,使得瘢痕治疗更趋于多元化和综合化.因此临床医师在瘢痕治疗中面临更多选择的同时也面临许多挑战.结合传统治疗,不断开发新型治疗,多种治疗方法综合应用才是目前瘢痕治疗的主流趋势.%The prevention and treatment of scars has always been an important task in the field of wound repair.Humans have started treatment for scars long time ago and have created a series of treatments.At the same time,with the development of science and technology,the diagnosis and treatment of scars have made great progress.Through the basic research for new therapeutic targets and innovative of treatment methods,treatment for scar turns more diversified and integrated.As a result,clinicians will suffer many challenges while having more options for scars treatment.Combined with traditional treatment,developing new treatments,and the comprehensive therapy of multiple treatment methods is the mainstream trend of scar treatment.
    • 李娜; 杨丽; 程静; 韩军涛; 胡大海
    • 摘要: Objective To compare the efficacy and safety of pulsed dye laser with different parameters in the treatment of hypertrophic scar after burn.Methods From January 2016 to June 2016,122 patients with hypertrophic scar after burn were treated in our unit.The data were analyzed retrospectively.According to the pulse width and energy of pulsed dye laser treatment,there were 31 cases with 0.45 ms-low energy,28 cases with 0.45 ms-high energy,37 cases with 1.5 ms-low energy and 26 cases with 1.5 ms-high energy,which were treated once every 3-4 weeks.The Vancouver Scar Scale (VSS) was used to evaluate the scar condition before and after treatment,and the pain of patients was scored by VAS before and after treatment.The blood flow of scar site was monitored before and 12 months after treatment,and the blood perfusion was recorded.The patients'satisfaction was recorded 3 to 6 months after treatment,and the satisfaction rate was calculated.Results (1) The VSS scores of 0.45 ms-low energy,0.45 ms-high energy,1.5 ms-low energy and 1.5 ms-high energy groups after treatment were significantly lower than those before treatment in each group (t =11.3,9.0,14.1,12.7,P < 0.05).After treatment,the VSS scores of each group decreased by (5.8 ± 1.1),(5.2 ± 1.4),(4.1 ±0.8) and (4.0 ±0.9),respectively,with significant differences among the four groups (F =4.2,P < 0.05).Except for 1.5 ms pulse width,there was no significant difference in the effect of low-energy and high-energy treatment (P > 0.05),but there was significant difference in the effect of other treatment groups(t =7.29,4.81,6.91,5.11,4.74,P <0.05).(2)The VAS scores of the 4 groups after treatment were significantly lower than those before treatment in each group (t =7.1,5.2,4.1,6.6,P < 0.05);the VAS scores of each group after treatment decreased by 3.9 ± 1.3,5.1 ± 0.9,3.5 ± 0.6,4.9 ± 0.9,respectively,with significant statistical differences among the four groups (F =8.8,P < 0.05).Regardless of the pulse width of 0.45 ms or 1.5 ms,the pain degree of scar improved more in the high energy group than in the low energy group (t =6.4,2.2,3.4,4.74,P <0.05).(3) Four groups of scar blood perfusion decreased.(4) The satisfaction of the four groups were 82.3%,79.1%,84.5%,77.7%,respectively.There was no significant difference in satisfaction evaluation among the four groups (P > 0.05).Conclusions The therapeutic effect of pulsed dye laser on hypertrophic scar is very exact,and the treatment parameters of 0.45 ms pulse width and low energy 4-6 J/cm2 are recommended,which provide clinical basis for the prevention and treatment of scar and the application of pulsed dye laser.It is worthy of clinical application.%目的 比较脉冲染料激光不同参数治疗烧伤后增生性瘢痕的疗效及安全性.方法 回顾性分析2016年1月至2016年6月本院收治122例烧伤后增生性瘢痕患者的临床资料.根据脉冲染料激光治疗脉宽与能量不同,分为0.45 ms-低能量组31例,0.45 ms-高能量组28例,1.5 ms-低能量组37例,1.5 ms-高能量组26例,间隔3~4周治疗1次,治疗前及治疗结束后采用温哥华瘢痕量表(VSS)对瘢痕情况进行评分,采用VAS法对患者疼痛进行评分;治疗前及治疗12个月监测瘢痕部位血流,记录血流灌注量;记录治疗结束后3~6个月患者满意度,并计算满意率.结果 (1)0.45 ms-低能量、0.45 ms-高能量、1.5 ms-低能量、1.5 ms-高能量四组治疗后VSS的评分明显低于各组治疗前(t=11.3、9.0、14.1、12.7,P<0.05),各组治疗后评分依次分别下降(5.8±1.1)分、(5.2±1.4)分,(4.1±0.8)分、(4.0±0.9)分,四组比较差异有统计学意义(F=4.2,P<0.05).除1.5 ms脉宽下,低能量与高能量治疗效果差异无统计学意义(P>0.05),其他治疗组两两比较治疗效果差异均有统计学意义(t=7.29,4.81,6.91,5.11,4.74,P<0.05).(2)0.45 ms-低能量、0.45 ms-高能量、1.5 ms-低能量、1.5 ms-高能量四组治疗后VAS评分明显低于各组治疗前(t=7.1、5.2、4.1、6.6,P<0.05);各组治疗后评分依次分别下降(3.9±1.3)分、(5.1±0.9)分,(3.5±0.6)分、(4.9±0.9)分,四组间比较差异有统计学意义(F=8.8,P<0.05).不论是0.45 ms或1.5 ms脉宽下,高能量组瘢痕疼痛程度改善较低能量组更多(t=6.4,2.2,3.4,4.74,P<0.05).(3)0.45 ms脉宽组瘢痕血流灌注明显下降.(4)四组患者满意度分别达82.3%,79.1%,84.5%,77.7%,四者间满意度评价差异无统计学意义(P>0.05).结论 脉冲染料激光对增生性瘢痕的疗效非常确切,且推荐0.45 ms脉宽、低能量4 ~6 J/cm2的治疗参数,为瘢痕的防治、脉冲染料激光的应用提供了临床依据.
    • 陈晓霞; 贺斌; 苏红辉; 周建大; 瞿思维; 韩笑; 陈孜孜; 陈佳; 李萍; 尹朝奇; 曾赛男; 王爱军
    • 摘要: Objective To explore the differences in autophagic expression levels between hypertrophic scar (HS) tissue and normal skin tissue,and further investigate the relationship between hypertrophic scar formation and autophagy protein expression through the rabbit ear hypertrophic scar model.Methods 30 patients with hypertrophic scar were collected.One hypertrophic scar tissue and one normal skin tissue were harvested.The relative expressions of LC3,P62 and Beclin-1 in each tissue specimen were detected by immunohistochemistry and Western blot.Western blot was used to detect the autophagic-associated protein LC3 (MAPLC3),P62 and Beclin-1 in the hypertrophic scar tissue of rabbit ear and the corresponding normal tissue of rabbit ears at 4 weeks,8 weeks,12 weeks,and 24 weeks,and further explore their clinical significance.Results In vivo,the expression of hypertrophic scar tissue protein LC3 and Beclin-1 was significantly stronger than that in normal skin tissue (P < 0.05).The expression of P62 was significantly weaker than that in normal skin tissue (P < 0.05).In animal experiments,during the process of HS formation,the protein expression of LC3 gradually increased,while the protein expression of P62 gradually decreased;the protein expression of Beclin-1 was higher than that of normal rabbit ears tissue,with statistically significant differences (P < 0.05).Conclusions The expression of LC3 and Beclin-1 in human hypertrophic scar tissues is higher than that in normal tissues.While the expression of P62 is lower than that in normal tissues.That is,the expression of autophagy in human hypertrophic scar tissue showed an upward trend in a certain period of time,and was significantly higher than that in normal tissue.%目的 探究增生性瘢痕(HS)组织与正常皮肤组织中自噬相关蛋白表达水平的差异,并通过兔耳增生性瘢痕模型进一步探讨增生性瘢痕形成过程与自噬相关蛋白表达的关系.方法 收集增生性瘢痕患者30例,各切取1处增生性瘢痕组织、1处正常皮肤组织,通过免疫组化、Western blot检测各组织标本中LC3、P62及Beclin-1的蛋白表达;采用Western blot分别检测4、8、12、24周兔耳增生性瘢痕组织与对应的兔耳正常组织中自噬相关蛋白LC3、P62及Beclin-1的表达,并进一步探讨其临床意义.结果 增生性瘢痕患者的瘢痕组织LC3、Beclin-1的表达显著强于正常皮肤组织中的表达(P<0.05),P62的表达显著弱于正常皮肤组织中的表达(P<0.05).兔耳增生性瘢痕模型HS形成过程中,LC3蛋白表达量逐渐升高;P62蛋白表达量逐渐下降;Beclin-1蛋白表达量均高于兔耳正常组织,差异均有统计学意义(P<0.05).结论 人体增生性瘢痕组织中LC3、Beclin-1的表达量高于正常组织,P62的表达量低于正常组织,即增生性瘢痕形成过程与自噬相关蛋白的表达有关.
    • 贾铠宁; 许尧祥; 于果; 岳金; 刘峰; 肖文林
    • 摘要: Objective To investigate the effect of p38MAPK gene silencing recombinant adeno-virus on the expression of target gene in different time and to detect the effect of p 38MAPK signal pathway on the upper lip scar hyperplasia at different time to determine the optimal scar treatment time .Methods The adenovirus vector was injected into the scar tissue in 0 week ,1 week and 2 week after cheiloplasty in rabbit .The specimens were harvested in 3 week postoperatively .Four methods in-cluding Sirius red staining ,immunohistochemical staining (IHC) ,Western blotting (WB) ,real-time PC (RT-PCR) were used to quantitatively and quantitatively detect the relative expression levels of p38MAPK and scar-related factors (col Ⅰ ,col Ⅲ ,MM P1 ,TIMP1) .Results Sirius red staining and immunohistochemical staining showed that in 1st week the expression of col Ⅲ and MMP1 in scar tis-sue was significantly higher than that in 0 week and 2 week after operation and the expression of col Ⅰand TIMP1 was significantly less than that in 0 week and 2 week after operation .The results of WB and RT-PCR were consistent with that of IHC .Conclusions After injection into the upper lip scar tis-sue with adenovirus in 1 week ,the degree of scar hyperplasia is the least .%目的 应用p38MAPK基因沉默重组腺病毒干扰靶基因的表达,检测不同时间p38MAPK信号通路受阻对兔上唇瘢痕增生的影响.方法 在兔唇裂术后0、1、2周分别进行瘢痕组织局部p38MAPK基因沉默腺病毒注射,在术后3周获取标本.用天狼猩红染色 、免疫组织化学染色 、Western blotting、实时定量荧光PCR定性 、定量检测p38MAPK及瘢痕形成相关因子胶原蛋白Ⅰ 型(colⅠ)、胶原蛋白 Ⅲ 型(colⅢ)、基质金属蛋白酶1(MMP1)、金属蛋白酶组织抑制因子(TIM P1)蛋白和mRNA表达.结果 局部注射腺病毒后,天狼猩红染色:术后1周瘢痕组织colⅢ 表达明显高于术后0周及2周,colⅠ 表达明显低于术后0周及2周.免疫组织化学染色 、Western印迹和实时定量荧光PCR结果显示:术后1周瘢痕组织colⅢ 、MM P1表达明显高于术后0周及2周,colⅠ 、TIMP1表达明显低于术后0周及2周.结论 兔唇裂术后1周抑制p38MAPK表达,瘢痕增生最轻.
    • 邱实; 宛利民
    • 摘要: 目的 观察2940 nm点阵激光联合倍他米松局部封闭治疗增生性瘢痕的临床疗效.方法 对2015年1月至2016年12月期间,在北京市顺义区医院皮肤科门诊就诊的43例增生性瘢痕病人,先使用复方倍他米松注射液(得宝松)适量药液缓慢注射入皮损内,间隔治疗时间4周,根据皮损增生程度注射1~4次,最后一次注射完毕间隔1个月后,采用Pixel 2940 nm点阵激光进行治疗.治疗结束后随访3个月.同时对病人进行满意度调查.结果 43例病人经1~5次治疗后,有效率分别为48.84%、60.47%、82.50%、91.43%、96.30%,有效率随治疗次数的增加显著增加,病人满意率为93.02%.不良反应少.结论 2940 nm点阵激光联合局部封闭治疗增生性瘢痕,疗效确切,值得推广应用.
    • 范娅琦; 郭碧蓉; 曾维惠; 刘亚乐
    • 摘要: 目的 初步探讨早期防治兔耳增生性瘢痕形成的最佳激光能量密度及其可能的治疗机制.方法 12只健康新西兰大耳白兔,在10只兔耳部进行增生性瘢痕造模,成功形成61处增生性瘢痕,随机分为2组(1周组30处和3周组31处).这两组兔耳瘢痕又分别随机分为A组(密度100PPA、能量10mJ激光)、B组(100 PPA、50 mJ激光)、C组(169 PPA、10mJ激光)、D组(169 PPA、50 mJ激光)、E组(不接受激光处理).除去3周组E组外,余均为每组6处瘢痕.2只大耳白兔未行瘢痕造模,作为F组(空白对照组).免疫组化观察干预后1周兔耳皮肤组织中MMP-13表达情况,干预后3周兔耳皮肤组织行HE、Masson染色,观察瘢痕结构,计算瘢痕增生指数.各组瘢痕增生指数的比较采用Kruskal-Wallis H检验,MMP-13平均吸光度的比较采用单因素方差分析.结果 HE染色显示,A、B、C、D各组真皮层厚度较F组(正常皮肤组织)增厚,胶原纤维数量增加,但较E组(未处理瘢痕组)真皮厚度明显变薄,胶原纤维数量减少,排列相对有秩.A、B、C、D组间真皮层厚度未见明显差异.6组间瘢痕增生指数差异有统计学意义(H=22.757,P<0.05).两两多重比较显示,B、C、D组瘢痕增生指数(2.597±0.344、2.850±0.282、2.658±0.134)均显著低于E组(3.460±0.583,均P<0.05).Masson染色显示,A、B、C、D各组真皮层厚度较E组明显变薄,胶原纤维排列不规则,但A、B、C、D各组间真皮层厚度及胶原纤维数量未见明显差别.免疫组化显示,在相同激光密度条件下,高能量(50 mJ)组的MMP-13表达水平明显高于低能量(10 mJ)组(P<0.05);而相同激光能量条件下,A组MMP-13水平显著高于C组(P<0.01),但B组与D组间差异无统计学意义(P>0.05).结论 非剥脱点阵激光对于早期增生性瘢痕的干预有效.相同密度下,50 mJ能量激光干预效果优于10mJ能量激光,推测高能量激光能更好刺激细胞外基质的重组以及上调MMP-13的表达,从而早期防治增生性瘢痕.%Objective To preliminarily optimize the energy and density of laser radiation for the early treatment of hyperplastic scars in a rabbit ear model,and to explore possible therapeutic mechanisms.Methods Sixty-one hyperplastic scars were successfully established on the ears of 10 healthy New Zealand white rabbits with large ears,and randomly divided into 2 groups:1-week group (30 scars) and 3-week group (31 scars).These 2 groups were separately divided into 5 subgroups:group A treated with laser at a density of 100 PPA and an energy of 10 mJ,group B with laser at a density of 100 PPA and an energy of 50 mJ,group C with laser at a density of 169 PPA and an energy of 10 mJ,group D with laser at a density of 169 PPA and an energy of 50 mJ,and group E receiving no treatment.There were 6 scars in each group,except the group E in the 3-week group.Two healthy New Zealand white rabbits with large ears were not subjected to modeling,and served as group F (blank control group).Immunohistochemical study was performed to determine the expression of matrix metalloproteinase (MMP)-13 in the skin tissues from the rabbit ears 1 week after the treatment.Three weeks after the treatment,the skin tissues from the rabbit ears were subjected to hematoxylin-eosin (HE) staining and Masson staining.Then,the structure of scars was observed,and scar elevation index was calculated.Statistical analysis was carried out by Kruskal-Wallis H test for the comparison of scar elevation index,and by one-way analysis of variance (ANOVA) for the comparison of the average absorbance value of MMP-13.Results As HE staining revealed,the groups A,B,C and D all showed thicker dermis and increased number of collagen fibers compared with the group F (normal skin tissues),but showed thinner dermis,decreased number and more ordered arrangement of collagen fibers compared with the group E (untreated scar tissues).No obvious difference was observed in the thickness of the dermis among the groups A,B,C and D.The scar elevation index significantly differed among the 6 groups (H =22.757,P < 0.05).Multiple comparisons showed that the scar elevation index was significantly lower in the groups B,C and D (2.597 ± 0.344,2.850 ± 0.282,2.658 ± 0.134,respectively)than in the group E (3.460 ± 0.583,all P < 0.05).As Masson staining revealed,the groups A,B,C and D all showed thinner dermis and more irregular arrangement of collagen fibers compared with the group E.However,no obvious differences were observed in the dermal thickness or number of collagen fibers among the groups A,B,C and D.Immunohistochemical study showed that the expression of MMP-13 was significantly higher in the high-energy (50 mJ) laser groups than in the low-energy (10 mJ) laser groups (P < 0.05) at the same laser density.With the same laser energy,the expression of MMP-13 was significantly higher in the group A than in the group C (P < 0.01),but there was no significant difference between the group B and D (P > 0.05).Conclusions Non-ablative fractional laser is effective for the treatment of early-stage hyperplastic scars.At the same laser density,50-mJ laser was superior to 10-mJ laser for the treatment of hyperplastic scars,likely because high-energy laser can stimulate the recombination of extracellular matrices and up-regulated MMP-13 expression to a greater extent.
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