无针注射器瘢痕疙瘩内注射糖皮质激素的疗效研究

目的 比较无针注射器与普通注射器瘢痕疙瘩内注射糖皮质激素的疗效。 方法 瘢痕疙瘩患者60例分为无针注射器组31例，普通注射器组29例。两组均使用复方倍他米松注射液进行皮损内注射，注射剂量0.2 ml/cm3，均为3周1次，连续3次。收集入组病例每次治疗前后参数数据、不良反应观察指标和每次治疗前后临床照片。采用Mann-Whitney检验、χ2检验等对两组参数数据进行统计学分析。 结果 第1次和第2次注射时间、第1次注射后疼痛时间Mann-Whitney检验U值分别为299.000、773.500、730.000，P值分别为0.000、0.000、0.003，其差异有统计学意义。3次治疗后体积、高度、硬度、痛觉、痒觉、外观评价、注射点数Mann-Whitney检验U值分别为295.000、336.500、264.000、464.000、451.500、308.000、233.500，P值分别为0.001、0.007、0.000、0.041、0.043、0.003、0.001，其差异均有统计学意义。两组3次治疗后不良反应发生率比较，差异无统计学意义（均P > 0.05）。无针注射器组皮损反跳临界时间11.8 d（95% CI：10.96 ~ 12.6 d）比普通注射器组皮损反跳临界时间21.2 d（95% CI：13.96 ~ 28.45 d）短。 结论 无针注射器治疗瘢痕疙瘩与普通注射器相比，疗效好，又可以降低注射难度，提高患者治疗依从性。

Evaluation of efficacy of intralesional glucocorticoid injection with a needle-free injector for the treatment of keloid

Wu Xiaoyan*, Fan Hongmei, Chen Xiaodong, Xu Pan, Yao Xiaodong. *Department of Dermatovenereology, Affiliated Hospital of Nantong University, Nantong 226001, China Corresponding author: Chen Xiaodong, Email: dermatochen@163.com 【Abstract】 Objective To compare the efficacy of intralesional glucocorticoid injection with a needle-free injector versus an ordinary injector for the treatment of keloid. Methods A total of 60 patients with keloid were enrolled and randomly divided into two groups by using a random number table to receive intralesional injection of compound betamethasone with a needle-free injector （n = 31） or an ordinary injector （n = 29）. The injection was given at a dose of 0.2 ml/cm3 once every 3 weeks for 3 sessions. Parameters for therapeutic efficacy were assessed, adverse reactions were recorded, and clinical pictures were taken before and after each treatment. Statistical analysis was carried out by the Mann-Whitney U test and chi-square test with the SPSS 19.0 software. Results Compared with the ordinary injector group, the needle-free injector group showed significantly different injection time during the first and second treatment （U = 299.000, 773.500, respectively, both P = 0.000）, as well as duration of pain after the first injection （U = 730.000, P = 0.003）. After three sessions of treatment, there was a significant difference in the volume, height, hardness of keloid, scores for pain, itching and appearance, and number of injection points between the needle-free injector group and ordinary injector group （U = 295.000, 336.500, 264.000, 464.000, 451.500, 308.000, 233.500, P = 0.001, 0.007, 0.000, 0.041, 0.043, 0.003, 0.001, respectively）. No significant differences were observed in the incidence of adverse reactions between the two groups （all P > 0.05）. Moreover, the interval for lesion recurrence was significantly shorter in the needle-free injector group （11.8 days, 95% CI: 10.96 － 12.6 days） than in the ordinary injector group （21.2 days, 95% CI: 13.96 － 28.45 days）. Conclusion Compared with the ordinary injector, the needle-free injector shows better efficiency for the treatment of keloid with decreased difficulty in injection and improved compliance in patients.