MEBO SCAReducer Combined with Ultrasonic Therapy to Treat Hyperplastic Scars of Facial Trauma

【摘要】目的:探讨面部软组织外伤增生性瘢痕的最佳治疗方法。方法:美宝疤痕平均匀涂于瘢痕处,配合超声治疗仪治疗。结果:治疗1个月~3个月,瘢痕的色泽由红紫变浅变淡,瘢痕的硬度逐渐变软;治疗3个月~6个月,瘢痕变为平、软,色泽恢复接近正常皮肤。78例92处瘢痕治愈68处,有效24处,治愈率为73.92℅。随访半年,治愈的病人未见瘢痕复发。结论:美宝疤痕平与超声波联合可有效治疗面部外伤增生性瘢痕。
【关键词】增生性瘢痕;面部外伤;疤痕平;超声波
【中图分类号】R619.6;R454.3【文献标识码】B【文章编号】1001-0726(2008)01-0028-02

MEBO SCAReducer Combined with Ultrasonic Therapy to Treat Hyperplastic Scars of Facial Trauma.

HUANG Xing-yu. Department of Burns, Zhongshan Huangpu People’s Hospital, Zhongshan City, Guangdong Province, 528429, China.

【Abstract】

Objective: To study the best therapy for treating hyperplastic scars of trauma on facial soft tissue.

Method: MEBO SCAReducer was applied evenly to scar sites, combined with treatment of sonostat.

Results:
After treatment of 1-3 months, the color of scars was reduced into more light from reddish violet , and scars’ hardness gradually became soft.

After treatment of 3-6 months, scars became even, soft, and their color almost recovered to normal skin.

In the results of treating 92 scars of 78 patients, 68 scars were treated well, 24 effective, and effective rate was 73.92%. Following up for half of a year, no scar relapse was observed in the treated scars effectively.

Conclusion: MEBO SCARducer combined with ultrasonic is effective of treating hyperplastic scars of facial trauma. 

【Key words】MEBO SCAReducer; Hyperplastic scars; Combined therapy

一、资料与方法
1.病例资料:2004年1月~2006年9月,我院共治疗78例92处皮肤瘢痕,男性50例,女性28例,年龄10岁~60岁。瘢痕分布情况:额部24处,面颊部25处,鼻部15处,下颌部28处。
2. 瘢痕的严重程度和积分标准:(1)色泽赤红或鲜红伴毛细血管扩张记3分,淡红色按压后消失记2分,暗紫记1分,达正常肤色记0分。(2)瘙痒:剧烈严重或持续性瘙痒记3分,经常性瘙痒但可忍受记2分,间断瘙痒记1分,无痛觉记0分。(3)硬度:坚硬如软骨记3分,硬度似橡皮记2分,稍硬记1分,无硬度记0分。总分在10分以上为重度,6~10分为中度,1~5分为轻度。
根据上述积分标准,78例病人92处瘢痕属于重度者65处,中度者18处,轻度9处。
3.治疗方法:清洗面部,将美宝疤痕平均匀涂于患处,用超声波治疗仪轻压于面部患处皮肤,均匀缓慢直线往返移动或旋转移动,每次15分钟,每天1次,连续治疗6个月。
二、疗效标准与结果 
1.疗效标准:(1)治愈:痛痒消失,色泽接近正常,瘢痕完全软化变平,触之柔软无硬结,随访半年无复发。(2)有效:痛痒显著减轻,色泽由红转暗,有60℅~70℅的瘢痕面积软化、变平,或严重程度由重度转为中度或轻度者。(3)无效:痛痒色泽及硬度有所减轻或无变化。
2.结果:通过对美宝疤痕平联合超声治疗78例92处面部外伤增生性瘢痕病人的临床观察,在治疗过程中病人的瘙痒症状明显减轻,治疗1个月后瘙痒症状基本消失。治疗1个月~3个月,瘢痕的色泽由红紫变浅变淡,瘢痕的硬度逐渐变软;治疗3个月~6个月,瘢痕变为平、软,色泽恢复接近正常皮肤。78例92处瘢痕治愈68处,有效24处,治愈率为73.92℅。随访时间最低半年,治愈的病人未见瘢痕复发。部分治疗有效病人继续治疗仍可达到治愈。
三、讨论
瘢痕是创伤修复的产物,是创伤创面在经过炎症期,增生期,重塑期过程中,由白细胞、巨噬细胞、肥大细胞不断浸润,并释放出多种细胞因子,其中成纤维细胞和肌成纤维细胞增生比较明显,而胶原纤维呈现无规则排列。同时瘢痕中有高浓度酸性粘多糖类基质沉积,且有大量硫酸软骨素A使得瘢痕变硬[1]。另外,上皮细胞与胶原纤维由于缺乏生理调控机制,生长比例失调,导致胶原合成和降解过程出现不平衡,以致异常粘多糖的出现和肌纤维细胞的过度增殖导致局部增生隆起,色泽潮红,坚硬,,痛痒、干燥、功能受限。美宝疤痕平主要成份是亚油酸、芝麻素、酚酸、仙人掌精等,这些成份可以调整上皮细胞的比例,具有抑制成纤维细胞及胶原纤维过度增生,加速其降解,及止痛、止痒作用[2]。本研究证明,美宝疤痕平与超声联合是当前治疗面部增生性瘢痕的理想药物,它对面部色素沉着的改善也有一定治疗作用。
参考文献
[1]宋儒耀.美容整形外科学[M].北京出版社,1994.179.
[2]徐荣祥.美宝疤痕平的护肤原理及使用说明[J].中国烧伤创疡杂志,1995,(1):封3-4.
【作者简介】
黄杏玉(1973~),女(汉族),广东中山市人,湛江中医学院毕业,主治医师.