高频超声生物显微镜动态观察局部注射二丙酸倍他米松治疗病理性瘢痕

目的采用高频超声生物显微镜(HFB,40MHz)观察二丙酸倍他米松治疗病理性瘢痕的临床效果。方法对39例接受二丙酸倍他米松局部注射治疗患者(治疗组)和20例未接受任何治疗患者(对照组)以40MHz探头行高频超声,于第1、31、61、91天测量瘢痕横径、垂直厚度;以DFY型超声图像诊断仪测量其面积、平均灰度值、声强值;结合温哥华瘢痕量表(VSS)对瘢痕评分。结果治疗组:第31、61、91天较治疗前横径、垂直厚度明显减小(P均0.05),面积、平均灰度值、平均声强值明显减小(P均0.05),VSS评分明显降低(P均0.01);第61天较第31天、第91天较第61天以上各参数均明显减小(P0.05),评分明显降低(P0.01)。对照组:各参数及评分均降低,但差异无统计学意义(P均0.05)。结论高频超声显微镜能无创、定量观察二丙酸倍他米松局部治疗后病理性瘢痕改变,对评价治疗情况有一定临床价值。

High frequency ultrasound in dynamic observation on effect of local injection with diprospan for treating pathological scar

Objective To explore the application value of high frequency ultrasound in dynamic observation on the therapeutic effect of pathological scar with local injection of diprospan. Methods Thirty-nine patients who received diprospan therapy (treatment group) and 20 patients without therapy (control group) were enrolled. High frequency ultrasound biomicroscopy (HFB, 40 MHz) was used to observe the dynamic changes of the depth and diameter, and DFY ultrasound image analyzer was used to measure the area, intensity and grey of the scar. VSS was combined to assess the scar. Results In treatment group, on the 31th, 61th and 91th day after injection, the depth and diameter measured with HFB significantly decreased, so did the area, intensity and grey index compared with pre-injection (all P<0.05). In addition, VSS scores decreased significantly compared with pre-injection (P<0.01). Compared to those on the 31th day, parameters and score decreased apparently on the 61th day (P<0.05 for parameters and P<0.01 for score), so did those on the 91th day compared with 61th day. In control group, all parameters and score reduced, but there was no statistical difference (all P>0.05). Conclusion HFB may be used as a real-time, non-invasive observation method to evaluate therapeutic effect of local injection of diprospan for pathological scar, therefore being valuable in clinical application.