额部外伤清创缝合术后即刻注射A型肉毒毒素防治瘢痕的效果

目的探讨额部外伤清创缝合术后即刻注射A型肉毒毒素防治瘢痕的临床效果。方法从2016年1月至2018年1月于陆军军医大学大坪医院整形外科收治的152例额部外伤患者中选择伤口近乎垂直于Langer线的病例,行清创美容缝合,术后即刻于伤口边缘肌层注射A型肉毒毒素,浓度为每0.10 ml溶液中含2 U肉毒毒素。根据额肌力量每1 cm长注射0.05~0.10 ml(1~2 U),2个注射点间距为1 cm,注射范围为整个额部,以保证额部左右对称,注射总量不超过100 U。参考观察者瘢痕评估量表和温哥华瘢痕量表,在随访时评估患者额部伤口术后瘢痕的色泽、宽度、质地、厚度、有无疼痛及瘙痒等。结果共纳入44例患者,男22例,女22例,年龄(31.5±8.4)岁,伤口长度为1~12 cm,平均3.5 cm,伤口周围肉毒毒素注射量为0.10~0.90 ml(2~18 U),额部注射总量为8~40 U。术后随访6~24个月。术后有1例患者发生轻到中度上睑下垂,1个月左右症状完全消失。术后6周内,44例患者伤口瘢痕均呈粉红色且质硬,3~6个月以后,42例患者瘢痕颜色逐渐贴近肤色、质地变软,窄且平坦、无疼痛和瘙痒症状,患者表示满意,满意率达95.5%(42/44),2例患者因瘢痕色素沉着和瘢痕略宽不满意。结论额部外伤清创缝合术后即刻注射A型肉毒毒素能有效防治瘢痕,患者满意度较高。     

CO2点阵激光联合A型肉毒毒素注射技术治疗面部外伤后手术缝合 瘢痕的临床观察

目的 观察CO2点阵激光联合A型肉毒毒素注射技术治疗面部外伤后手术缝合瘢痕的治疗效果及 安全性。方法 选取2019年7月-2021年1月苏北人民医院医学美容科就诊的60例面部外伤后手术缝合瘢痕患 者,采用随机数字表法分为试验组和对照组,各30例。对照组予以CO2点阵激光治疗,试验组在CO2点阵激 光治疗后予以A型肉毒毒素局部注射,比较两组温哥华瘢痕量表（VSS）评分、临床疗效、不良反应发生情 况及患者满意度。结果 两组治疗后1、6个月VSS权重评分低于治疗前,且试验组低于对照组,差异有统计 学意义（P＜0.05）;试验组治疗后1个月治疗总有效率高于对照组,差异有统计学意义（P＜0.05）;两组 治疗后6个月治疗总有效率比较,差异无统计学意义（P＞0.05）;试验组满意度高于对照组,差异有统计 学意义（P＜0.05）;两组色素沉着发生率比较,差异无统计学意义（P＞0.05）。结论 CO2点阵激光联合A 型肉毒毒素注射技术治疗面部外伤后手术缝合瘢痕的疗效确切,可改善瘢痕外观,且不增加不良反应发生 几率,应用安全性较高。     

联合A 型肉毒毒素治疗对急性阑尾炎术后切口瘢痕增生的影响

目的:探索联合A型肉毒毒素使用是否可以减轻急性阑尾炎手术术后切口瘢痕增生。方法:选取2018年3月2018年12月在北京丰台右安门医院行急性阑尾炎切除手术的80例患者,随机分为观察组和对照组,观察组在常规缝合后切口边缘注射A型肉毒毒素,对照组仅进行常规缝合,分别于术后1周、2周、1月和3月进行随访,采用视觉模拟评分法(VAS)评估术后疼痛情况;采用温哥华瘢痕量表对瘢痕的色泽、厚度、血管分布及柔软度4个指标判断瘢痕增生情况;比较两组的上述指标,记录并比较两组的术后切口愈合时间和术后满意度情况。结果:术后1天,两组患者各项指标差异无统计学意义,术后1周、2周、1月及3月,观察组的VAS评分明显低于对照组;术后1周,观察组的瘢痕厚度和血管分布及术后2周、1月和3月的瘢痕色泽、厚度、血管分布及柔软度评分均低于对照组;观察组术后切口愈合时间短于对照组,且观察组患者满意度高于对照组,差异均有统计学意义(P均<0.05)。结论:急性阑尾炎切除手术术后行切口缝合时,联合A型肉毒毒素使用在一定程度上可以减轻切口瘢痕增生。     

A型肉毒毒素局部应用对兔耳增生性瘢痕创面愈合和瘢痕增生的影响

目的 研究A型肉毒毒素对兔耳增生性瘢痕组织的影响.方法 8只日本大耳白兔,体重3 kg,建立兔耳增生性瘢痕模型.将兔耳创面分为A型肉毒毒素治疗组(T组)和瘢痕组(S组),每组48个创面.大体观察创面愈合时间和瘢痕增生情况.术后28 d,同法另取4只兔子的兔耳腹面健康皮肤为空白组(B组),收集标本.测量S、T组标本HE切片的瘢痕增生指数HI,流式细胞仪分析2组标本中成纤维细胞的细胞周期,western-blot检测S、T、B组标本中Ⅰ、Ⅲ型胶原的蛋白表达.结果 ①T组标本的瘢痕增生指数HI较S组显著降低,P<0.01;②蛋白水平上,T组的胶原Ⅰ、Ⅲ蛋白表达和胶原Ⅰ/Ⅲ比值均较s组显著降低,P<0.01;③S组分布于G2-M期和S期的成纤维细胞较T组显著增多,而静止期G0-G1的细胞则显著减少,P<0.05.结论 A型肉毒毒素局部应用能抑制兔耳增生瘢痕的形成.抑制成纤维细胞的增殖活性,减少瘢痕组织中Ⅰ、Ⅲ型胶原的合成,降低胶原Ⅰ/Ⅲ比值,为其治疗增生性瘢痕的临床应用提供了一定的理论依据.     

A型肉毒毒素在面部直线形瘢痕修复术中的应用

目的探讨A型肉毒毒素在面部直线形瘢痕修复术中应用的合理性和可行性。方法选择2009年3月至2012年3月在我院整形科接受面部瘢痕修复术,术中应用A型肉毒毒素进行局部注射的39例患者作为治疗组;另选取2006年3月至2009年3月在我院整形科接受单纯面部瘢痕切除的42例患者作为对照组。采用国际推荐的OSAS瘢痕评价量表,由两位经验丰富的整形医师对两组患者术前及术后1年的瘢痕情况进行评估,分别从瘢痕颜色、平整度、弹性程度及瘢痕宽度4个方面对瘢痕的整体情况进行评估打分,对每组术前、术后及两组的情况进行对比,进行统计学分析。结果治疗组和对照组术前瘢痕的颜色、平整度、弹性和宽度4个方面相比,差异无统计学意义（P〉0．05）。对照组术后瘢痕的颜色、弹性与术前相比,差异无统计学意义（P〉0．05）,平整度明显改善,宽度明显缩窄,与术前相比,差异具有统计学意义（P〈0．05）;治疗组术后与术前相比瘢痕的颜色、平整度、弹性和宽度均有明显的改善,差异具有统计学意义（P〈0．05）;治疗组术后和对照组术后相比,瘢痕颜色更淡、弹性更好、宽度明显缩窄,差异具有统计学意义（P〈0．05）。结论A型肉毒毒素用于面部瘢痕修复后切口两侧注射可以明显改善术后瘢痕的质地,修复效果比较理想,值得在临床上推广应用。     

A型肉毒毒素局部应用对兔耳增生性瘢痕创面愈合和瘢痕增生的影响

Objective To investigate the effect of botulinum toxin type A (Botox A) injection on hypertrophic scar in rabbit ear model. Methods The hypertrophic scar model was established in 16 Japanese rabbits' ears. These wounds were divided into two groups as group T(treated with Botox A, n =48) and group S (not treated, n = 48). The wounds healing times and scar hypertrophy were observed with 8 specimen of normal skin at the rabbit ears as sham group B. HE stain was used to assess the hypertrophic index(HI). The expression of collagen Ⅰ and Ⅲ was tested by western-blot. The cell cycle of fibroblasts was studied by flow cytometry. Results The [] was significantly lower in group T than in group S(P < 0.01). The expression of collagen Ⅰ and Ⅲ, as well as the ratio of Ⅰ to Ⅲ, was markedly stronger in group S than in group T(P < 0.01). Compared with group T, more fibroblasts were in G2-M in gToup S and fewer in G0-G1 (P <0.05). Conclusions Local injection of Botox A can inhibite the formation of hypertrophic scar and the activity of fibroblasts in rabbit ear model. It can significantly decrease the expression of collagen Ⅰ and Ⅲ in hypertrophic scar, as well as the ratio of collagen Ⅰ to Ⅲ. It serves as the basis for the treatment of hypertrophic scar with Botox A.     

A型肉毒毒素局部应用对兔耳增生性瘢痕创面愈合和瘢痕增生的影响

Objective To investigate the effect of botulinum toxin type A (Botox A) injection on hypertrophic scar in rabbit ear model. Methods The hypertrophic scar model was established in 16 Japanese rabbits' ears. These wounds were divided into two groups as group T(treated with Botox A, n =48) and group S (not treated, n = 48). The wounds healing times and scar hypertrophy were observed with 8 specimen of normal skin at the rabbit ears as sham group B. HE stain was used to assess the hypertrophic index(HI). The expression of collagen Ⅰ and Ⅲ was tested by western-blot. The cell cycle of fibroblasts was studied by flow cytometry. Results The [] was significantly lower in group T than in group S(P < 0.01). The expression of collagen Ⅰ and Ⅲ, as well as the ratio of Ⅰ to Ⅲ, was markedly stronger in group S than in group T(P < 0.01). Compared with group T, more fibroblasts were in G2-M in gToup S and fewer in G0-G1 (P <0.05). Conclusions Local injection of Botox A can inhibite the formation of hypertrophic scar and the activity of fibroblasts in rabbit ear model. It can significantly decrease the expression of collagen Ⅰ and Ⅲ in hypertrophic scar, as well as the ratio of collagen Ⅰ to Ⅲ. It serves as the basis for the treatment of hypertrophic scar with Botox A.     

A型肉毒毒素局部应用对兔耳增生性瘢痕创面愈合和瘢痕增生的影响

Objective To investigate the effect of botulinum toxin type A (Botox A) injection on hypertrophic scar in rabbit ear model. Methods The hypertrophic scar model was established in 16 Japanese rabbits' ears. These wounds were divided into two groups as group T(treated with Botox A, n =48) and group S (not treated, n = 48). The wounds healing times and scar hypertrophy were observed with 8 specimen of normal skin at the rabbit ears as sham group B. HE stain was used to assess the hypertrophic index(HI). The expression of collagen Ⅰ and Ⅲ was tested by western-blot. The cell cycle of fibroblasts was studied by flow cytometry. Results The [] was significantly lower in group T than in group S(P < 0.01). The expression of collagen Ⅰ and Ⅲ, as well as the ratio of Ⅰ to Ⅲ, was markedly stronger in group S than in group T(P < 0.01). Compared with group T, more fibroblasts were in G2-M in gToup S and fewer in G0-G1 (P <0.05). Conclusions Local injection of Botox A can inhibite the formation of hypertrophic scar and the activity of fibroblasts in rabbit ear model. It can significantly decrease the expression of collagen Ⅰ and Ⅲ in hypertrophic scar, as well as the ratio of collagen Ⅰ to Ⅲ. It serves as the basis for the treatment of hypertrophic scar with Botox A.     

A型肉毒毒素局部应用对兔耳增生性瘢痕创面愈合和瘢痕增生的影响

Objective To investigate the effect of botulinum toxin type A (Botox A) injection on hypertrophic scar in rabbit ear model. Methods The hypertrophic scar model was established in 16 Japanese rabbits' ears. These wounds were divided into two groups as group T(treated with Botox A, n =48) and group S (not treated, n = 48). The wounds healing times and scar hypertrophy were observed with 8 specimen of normal skin at the rabbit ears as sham group B. HE stain was used to assess the hypertrophic index(HI). The expression of collagen Ⅰ and Ⅲ was tested by western-blot. The cell cycle of fibroblasts was studied by flow cytometry. Results The [] was significantly lower in group T than in group S(P < 0.01). The expression of collagen Ⅰ and Ⅲ, as well as the ratio of Ⅰ to Ⅲ, was markedly stronger in group S than in group T(P < 0.01). Compared with group T, more fibroblasts were in G2-M in gToup S and fewer in G0-G1 (P <0.05). Conclusions Local injection of Botox A can inhibite the formation of hypertrophic scar and the activity of fibroblasts in rabbit ear model. It can significantly decrease the expression of collagen Ⅰ and Ⅲ in hypertrophic scar, as well as the ratio of collagen Ⅰ to Ⅲ. It serves as the basis for the treatment of hypertrophic scar with Botox A.     

A型肉毒毒素局部应用对兔耳增生性瘢痕创面愈合和瘢痕增生的影响

Objective To investigate the effect of botulinum toxin type A (Botox A) injection on hypertrophic scar in rabbit ear model. Methods The hypertrophic scar model was established in 16 Japanese rabbits' ears. These wounds were divided into two groups as group T(treated with Botox A, n =48) and group S (not treated, n = 48). The wounds healing times and scar hypertrophy were observed with 8 specimen of normal skin at the rabbit ears as sham group B. HE stain was used to assess the hypertrophic index(HI). The expression of collagen Ⅰ and Ⅲ was tested by western-blot. The cell cycle of fibroblasts was studied by flow cytometry. Results The [] was significantly lower in group T than in group S(P < 0.01). The expression of collagen Ⅰ and Ⅲ, as well as the ratio of Ⅰ to Ⅲ, was markedly stronger in group S than in group T(P < 0.01). Compared with group T, more fibroblasts were in G2-M in gToup S and fewer in G0-G1 (P <0.05). Conclusions Local injection of Botox A can inhibite the formation of hypertrophic scar and the activity of fibroblasts in rabbit ear model. It can significantly decrease the expression of collagen Ⅰ and Ⅲ in hypertrophic scar, as well as the ratio of collagen Ⅰ to Ⅲ. It serves as the basis for the treatment of hypertrophic scar with Botox A.     

A型肉毒毒素局部应用对兔耳增生性瘢痕创面愈合和瘢痕增生的影响

Objective To investigate the effect of botulinum toxin type A (Botox A) injection on hypertrophic scar in rabbit ear model. Methods The hypertrophic scar model was established in 16 Japanese rabbits' ears. These wounds were divided into two groups as group T(treated with Botox A, n =48) and group S (not treated, n = 48). The wounds healing times and scar hypertrophy were observed with 8 specimen of normal skin at the rabbit ears as sham group B. HE stain was used to assess the hypertrophic index(HI). The expression of collagen Ⅰ and Ⅲ was tested by western-blot. The cell cycle of fibroblasts was studied by flow cytometry. Results The [] was significantly lower in group T than in group S(P < 0.01). The expression of collagen Ⅰ and Ⅲ, as well as the ratio of Ⅰ to Ⅲ, was markedly stronger in group S than in group T(P < 0.01). Compared with group T, more fibroblasts were in G2-M in gToup S and fewer in G0-G1 (P <0.05). Conclusions Local injection of Botox A can inhibite the formation of hypertrophic scar and the activity of fibroblasts in rabbit ear model. It can significantly decrease the expression of collagen Ⅰ and Ⅲ in hypertrophic scar, as well as the ratio of collagen Ⅰ to Ⅲ. It serves as the basis for the treatment of hypertrophic scar with Botox A.     

A型肉毒毒素局部应用对兔耳增生性瘢痕创面愈合和瘢痕增生的影响

Objective To investigate the effect of botulinum toxin type A (Botox A) injection on hypertrophic scar in rabbit ear model. Methods The hypertrophic scar model was established in 16 Japanese rabbits' ears. These wounds were divided into two groups as group T(treated with Botox A, n =48) and group S (not treated, n = 48). The wounds healing times and scar hypertrophy were observed with 8 specimen of normal skin at the rabbit ears as sham group B. HE stain was used to assess the hypertrophic index(HI). The expression of collagen Ⅰ and Ⅲ was tested by western-blot. The cell cycle of fibroblasts was studied by flow cytometry. Results The [] was significantly lower in group T than in group S(P < 0.01). The expression of collagen Ⅰ and Ⅲ, as well as the ratio of Ⅰ to Ⅲ, was markedly stronger in group S than in group T(P < 0.01). Compared with group T, more fibroblasts were in G2-M in gToup S and fewer in G0-G1 (P <0.05). Conclusions Local injection of Botox A can inhibite the formation of hypertrophic scar and the activity of fibroblasts in rabbit ear model. It can significantly decrease the expression of collagen Ⅰ and Ⅲ in hypertrophic scar, as well as the ratio of collagen Ⅰ to Ⅲ. It serves as the basis for the treatment of hypertrophic scar with Botox A.     

A型肉毒毒素局部应用对兔耳增生性瘢痕创面愈合和瘢痕增生的影响

Objective To investigate the effect of botulinum toxin type A (Botox A) injection on hypertrophic scar in rabbit ear model. Methods The hypertrophic scar model was established in 16 Japanese rabbits' ears. These wounds were divided into two groups as group T(treated with Botox A, n =48) and group S (not treated, n = 48). The wounds healing times and scar hypertrophy were observed with 8 specimen of normal skin at the rabbit ears as sham group B. HE stain was used to assess the hypertrophic index(HI). The expression of collagen Ⅰ and Ⅲ was tested by western-blot. The cell cycle of fibroblasts was studied by flow cytometry. Results The [] was significantly lower in group T than in group S(P < 0.01). The expression of collagen Ⅰ and Ⅲ, as well as the ratio of Ⅰ to Ⅲ, was markedly stronger in group S than in group T(P < 0.01). Compared with group T, more fibroblasts were in G2-M in gToup S and fewer in G0-G1 (P <0.05). Conclusions Local injection of Botox A can inhibite the formation of hypertrophic scar and the activity of fibroblasts in rabbit ear model. It can significantly decrease the expression of collagen Ⅰ and Ⅲ in hypertrophic scar, as well as the ratio of collagen Ⅰ to Ⅲ. It serves as the basis for the treatment of hypertrophic scar with Botox A.     

A型肉毒毒素局部应用对兔耳增生性瘢痕创面愈合和瘢痕增生的影响

Objective To investigate the effect of botulinum toxin type A (Botox A) injection on hypertrophic scar in rabbit ear model. Methods The hypertrophic scar model was established in 16 Japanese rabbits' ears. These wounds were divided into two groups as group T(treated with Botox A, n =48) and group S (not treated, n = 48). The wounds healing times and scar hypertrophy were observed with 8 specimen of normal skin at the rabbit ears as sham group B. HE stain was used to assess the hypertrophic index(HI). The expression of collagen Ⅰ and Ⅲ was tested by western-blot. The cell cycle of fibroblasts was studied by flow cytometry. Results The [] was significantly lower in group T than in group S(P < 0.01). The expression of collagen Ⅰ and Ⅲ, as well as the ratio of Ⅰ to Ⅲ, was markedly stronger in group S than in group T(P < 0.01). Compared with group T, more fibroblasts were in G2-M in gToup S and fewer in G0-G1 (P <0.05). Conclusions Local injection of Botox A can inhibite the formation of hypertrophic scar and the activity of fibroblasts in rabbit ear model. It can significantly decrease the expression of collagen Ⅰ and Ⅲ in hypertrophic scar, as well as the ratio of collagen Ⅰ to Ⅲ. It serves as the basis for the treatment of hypertrophic scar with Botox A.     

A型肉毒毒素抑制病理性瘢痕形成机制的研究进展

A型肉毒毒素(botulinum toxin type A,BTXA)是一种神经调节剂,常用于医学美容领域.现已有大量研究显示,局部注射BTXA可安全有效地防治瘢痕,然而确切的分子机制仍不清楚.目前认为,BTXA可能通过降低伤口张力、调节miRNA水平、下调促纤维化因子表达、抑制成纤维细胞收缩、减少成纤维细胞数量和抑制...     

注射A型肉毒毒素在病理性瘢痕防治中的应用进展

增生性瘢痕和瘢痕疙瘩均属于病理性瘢痕,不仅会影响美观,还可能伴有瘙痒、疼痛等临床表现。然而,增生性瘢痕和瘢痕疙瘩发生的明确机制尚未完全清楚,治疗措施各异。A型肉毒毒素(Botulinum toxin type A,BTXA)是一种神经毒素,在肌肉痉挛性疾病的治疗和除皱美容方面均得到了广泛应用。近年来,有学者提出注射BTXA来预防和治疗病理性瘢痕,并进行了相关的基础与临床研究。本文着重对BTXA在治疗和预防增生性瘢痕和瘢痕疙瘩中的疗效、作用机制、使用方法、问题与展望等各方面的研究进展进行综述。     

不同时期注射A型肉毒毒素对兔耳增生性瘢痕的影响

目的 探讨不同时期注射A型肉毒毒素对兔耳增生性瘢痕的影响,以期发现A型肉毒毒素抑制瘢痕的最佳时间.方法 自2018年9月到2019年3月华中科技大学同济医学院动物实验中心选取健康的新西兰大耳兔18只,兔耳健全,雌雄不限,体质量2～3 kg,制作瘢痕模型.根据A型肉毒毒素注射时间分为即刻组(A组)、10 d组(B组)、3...     

A型肉毒毒素注射下面部提升术应用分析

目的:探讨使用A型肉毒毒素进行下面部提升的临床效果。方法:募集60例面部松垂的志愿者随机分成治疗组和对照组各30例。在单盲法的情况下,治疗组用A型肉毒毒素注射下颌缘处颈阔肌及降口角肌,对照组用等量0.9%氯化钠注射液同法注射。结果:治疗组总有效率为66.67%,对照组总有效率为16.67%,两者具有显著性统计学差异。结论:应用A型肉毒毒素注射行下面部提升安全、有效,可以推广应用。     

A型肉毒毒素注射治疗头痛的临床观察

目的观察A型肉毒毒素注射治疗头痛的效果。方法头痛病人20例,随机分为三组注射A型肉毒毒素。Ⅰ组,双侧皱眉肌每点注射25U;Ⅱ组,双侧皱眉肌和双额肌每点注射10U;Ⅲ组,除了双侧皱眉肌和额肌外,在降眉肌、颞肌、枕肌、头顶帽状腱膜或颈椎旁的明显压痛点注射5～10U,总量不超过100U。3个月后疼痛复发者可重复注射。结果治疗后第7天,三组的头痛视觉模拟评分(VAS)由治疗前7.2、7.1和7.3分降至2.8、2.3和2.5分,头痛程度比治疗前分别降低了67.5%、68.1%和68.8%,组间差异无显著意义。头痛发作次数由治疗前平均每周12.7、13.1和11.9次减少至5.0、4.9和4.7次,分别降低了60.6%、62.2%和60.5%;服用原镇痛药片由治疗前每周平均14.2、13.8和13.6片,分别减少至5.6、5.7和4.9片,比治疗前降低了60.5%、58.1%和63.9%;疗效维持是3.8、3.6和4.0个月;病人满意度分别为2.2、2.1和2.0分。Ⅲ组有1例感觉抬头乏力,2周后渐恢复。结论A型肉毒毒素注射可有效减轻头痛,但不同注射点和剂量对临床效果无明显影响。