摘要目的 探索局部注射平阳霉素治疗瘢痕疙瘩的最适合浓度、治疗效果及细胞组织变化.方法 48例患者随机分为4组,分别注射不同浓度的平阳霉素(1.000、0.500、0.250、0.125 mg/ml),每两周注射1次,5次后按温哥华瘢痕评分与治疗前评分相比,配对t检验;HE染色观察瘢痕组织形态学的改变.结果 4组中注射0.5 mg/ml浓度组治疗效果最佳(P=0.0026),与其他组的治疗效果比较差异有统计学意义(SNK 检验 P＜0.05);1年复发率为12.00%.组织学显示治疗后的瘢痕疙瘩表皮增厚,大量炎性细胞浸润,胶原纤维束粗细不一.结论 0.5 mg/ml 平阳霉素是每两周注射1次治疗瘢痕疙瘩的适合浓度,0.25 mg/ml为有效浓度;此方法简单易行,安全可靠,效果良好,复发率低,并发症少.

abstractsObjeetive To investigate the optimized concentration,effectiveness and histological change of Pingyangmycin by local injection of keloids for two weeks.Methods The appropriate concentration was analyzed,based on the Vancouver scar scale.48 eases of keloids were randomly divided into 4 groups with different concentrations of Pingyangmycin (1,0.5,0.25,and 0.125 mg/ml).Each case was iniected for five times at two weeks intervals,and then the statistical results (pair t test) and the histological changes were evaluated.Results Statistically,0.5 mg/ml group was more effective (P=0.0026),and this group had significant differences from the others (SNK test).The rate of the recurrence for one year was 12.00% in the whole effective cases.The keloid tissue after treatments,histologically,showed the thicker epidermis and larger papillary layer of the dermis,more inflammatory cells.Conclusions 0.5 mg/ml Pingyangmycin is the most appropriate concentration in this study and 0.25 mg/ml is the effective one.This treatment for keloid is convenient,safe,effective,low recrudescence and few side effects.