方建强 马杰 于晓锋

[摘要]目的：研究低浓度5-氟尿嘧啶联合曲安奈德注射治疗瘢痕疙瘩的美学效果。方法：选取2016年2月-2018年2月于笔者医院接受治疗的100例瘢痕疙瘩患者为研究对象，采用随机数字表法分为联合组和对照组，每组50例。对照组用曲安奈德注射液治疗，联合组用低浓度5-氟尿嘧啶联合曲安奈德注射液治疗，1周1次，持续治疗4周后，观察比较两组临床疗效、瘢痕评分及不良反应。结果：联合组总有效率（78.00%）明显高于对照组（58.00%）（P<0.05）;治疗前，两组瘢痕评分比较差异无统计学意义（P>0.05）;治疗后，两组中瘢痕评分与治疗前比较显著下降（P<0.05），对照组瘢痕评分明显著高于联合组（P<0.05）;两组治疗过程中均未出现严重不良反应。结论：低浓度5-氟尿嘧啶联合曲安奈德注射治疗瘢痕疙瘩疗效确切，有助于促进瘢痕软化，提高美容效果，且不会增加副反应，安全性好。

[关键词]瘢痕疙瘩;5-氟尿嘧啶;曲安奈德;美学效果

[中图分类号]R619+.6    [文献标志码]A    [文章编号]1008-6455（2021）04-0026-03

Analysis of Low Concentration 5-fluorouracil Combined with Triamcinolone Injection in the Treatment of Keloid

FANG Jian-qiang， Ma Jie， Yu Xiao-feng

（Department of Medical Cosmetology，Fuyang People's Hospital，Fuyang 236000，Anhui，China）

Abstract： Objective To investigate the aesthetic effect of low concentration 5-fluorouracil combined with triamcinolone injection in the treatment of keloid. Methods 100 patients with keloid in our hospital from February 2016 to February 2018 were enrolled， and randomly divided in two groups， each with 50 cases. Control group received the triamcinolone injection， while combined group received low concentration 5-fluorouracil combined with triamcinolone injection. Once a week， after 4 weeks of continuous treatment， the clinical effect， scar score and adverse reactions were observed and compared between the two groups. Results The total efficacy of combined group was higher than that of control group （78.00% vs 58.00%， P<0.05）. The scar score had no difference between groups before treatment （P>0.05）， which was decreased in both groups after treatment， and was lower in combined group than in control group （P<0.05）. There were no serious adverse reactions in the combined group and the control group. Conclusion Low concentration 5-fluorouracil combined with triamcinolone injection can effectively and safely make scar soft and improve the cosmetic effect for patients with keloidm without increasing the adverse reactions.

Key words：keloid; 5-fluorouracil; triamcinolone; aesthetic effect

瘢痕疙瘩是一種真皮纤维化疾病，是胶原超出最初皮肤损伤而浸润生长所致，具有持续性增生的特点。瘢痕疙瘩一般不易自行消退，多数还会出现破溃感染及严重痒痛，给患者带来痛苦[1]。瘢痕疙瘩治疗方法较多，有局部注射、加压治疗及手术等。单独使用以上治疗方法复发率较高，治疗效果不理想，目前国内外多主张多种治疗方法联合应用[2-3]。5-氟尿嘧啶是一种传统抗代谢药物，将该药局部注射入瘢痕损伤内疗效较好。曲安奈德是一种糖皮质激素药，通过激素来调节成纤维细胞的增殖和降解是瘢痕疙瘩治疗思路之一[4-5]。本研究以100例瘢痕疙瘩患者为研究对象，观察低浓度5-氟尿嘧啶联合曲安奈德注射治疗的疗效，现将结果报道如下。

1  资料和方法

1.1 一般资料：选取2016年2月-2018年2月笔者医院接受治疗的100例瘢痕疙瘩患者为研究对象，采用随机数字表法分为联合组和对照组，每组50例。……