PDF(Pubmed)
Abstract：
There are many methods to treat keloid, including various excision operations, laser, injection and radiotherapy. However, few studies have explored the effectiveness of single-hole punch excision in keloid treatment. This study aimed to investigate the efficacy and safety of lateral punch excision combined with intralesional steroid injection for keloid treatment through self-control trial. In this self-controlled trial, 50 patients meet the diagnosis of nodular keloid, and try to choose left-right symmetrical control, one skin lesion in the control group (50 skin lesionsin total) and the other in the observation group (50 skin lesions in total).The keloids in the treatment group were initially treated with punch excision combined with intralesional steroid injection, followed by injection treatment alone. Keloids in the control group received intralesional steroid injection alone. The Vancouver Scar Scale (VSS) of the keloid before and after the punch excision was evaluated; the keloid scores at different time points and the number of injection treatments required in both groups were compared, and adverse reactions were observed. The effective rate of the observation group was 86.0%, which was significantly higher than that of the control group (66.0%), and the recurrence rate of 22% was lower than that of the control group (χ2 = 4.141,63417), all of which were statistically significant (all P < 0.05). At the end of treatment, the VSS and total injection times in the observation group were significantly lower than those in the control group (t = 5.900,3.361), with statistical significance (P < 0.01). The combination of single-hole punch excision and intralesional steroid injection is an effective method to treat multiple nodular keloids, shortening the treatment course of tralesional steroid injection without obvious adverse reactions.
摘要：
治疗瘢痕疙瘩的方法有很多,包括各种切除手术，激光,注射和放疗。然而,很少有研究探讨单孔穿孔切除术在瘢痕疙瘩治疗中的有效性。本研究旨在通过自身对照试验,探讨侧穿孔切除联合病灶内注射类固醇治疗瘢痕疙瘩的疗效和安全性。在这个自控试验中,50例符合结节性瘢痕疙瘩诊断,并尝试选择左右对称控制，对照组皮肤病变1处(共50处),观察组皮肤病变50处。治疗组的瘢痕疙瘩最初采用穿孔切除联合病灶内注射类固醇治疗，其次是单独注射治疗。对照组仅接受病灶内类固醇注射瘢痕疙瘩。对打孔切除前后瘢痕疙瘩的温哥华瘢痕疙瘩量表(VSS)进行评价;比较两组不同时间点的瘢痕疙瘩评分和所需的注射治疗次数,观察不良反应。观察组有效率为86.0%,显著高于对照组(66.0%),22％的复发率低于对照组（χ2=4.141,63417），均有统计学意义(均P<0.05)。在治疗结束时,观察组的VSS和总注射次数明显低于对照组(t=5.900,3.361),具有统计学意义(P<0.01)。单孔打孔切除联合病灶内注射类固醇是治疗多发性结节性瘢痕疙瘩的有效方法,缩短激素治疗疗程，无明显不良反应。
