20 آذر 1395

بررسی مقایسه تاثیر تزریق داخل ضایعه ی وراپامیل با تزریق داخل ضایعه ی تریامسینولون استوناید در درمان اسکارهای هیپرتروفیک و کلوئید

مقدمه:كلوييدها و اسكارهاي هايپرتروفيك ناشي از رشد بیش ازحد كلاژن پوستي به دنبال آسیب به درم هستند كه به طور معمول منجربه مشكلات زيادي از نظر جسمي، رواني و زيبايي مي شوند. روش کار: در این مطالعه کارآزمایی بالینی دوسویه کور تصادفی شده با گروه کنترل، با طراحی گروه های زوجی، 50 بیمار دارای تعداد دو یا بیشتر کلوئید مورد بررسی قرار گرفت. در گروه کنترل (50 ضایعه)، تریامسینولون استوناید (با غلظت 40 میلی گرم در میلی لیتر) با فواصل 3 هفته یکبار برای مدت زمان کلی 18 هفته تزریق شد. در گروه دیگر (50 ضایعه)، ضایعات با وراپامیل (با غلظت 5/2 میلی گرم در میلی لیتر) با همان پروتکل درمانی قبل، تحت درمان قرار گرفتند. ارزیابی اسکارها در هر جلسه و نیز در پایان ماه سوم پیگیری توسط عکس برداری های سریال و نیز اندازه گیری مقیاس اسکار ونکوور (VSS) انجام شد. نتایج: میانگین امتیاز VSS صفر تنها در گروه تریامسینولون در مورد پارامترهای ارتفاع (هفته 15) و انعطاف پذیری (هفته 15) مشاهده شد. در گروه وراپامیل رخداد درمانی (رسیدن متغیر به صفر) و حتی هیچ بهبودی قابل ملاحظه در ضایعات مشاهده نشد. نتیجه گیری: نتایج ما از توانایی وراپامیل در درمان کلوئید و اسکارهای هیپرتروفیک پشتیبانی نمی کند.   كليد واژه ها : واژگان کلیدی: کلوئید، اسکار هیپرتروفیک، تریامسینولون، وراپامیل   مشخصات دانشجو: نام: پردیس ساسانی            رشته تحصيلي: بیماری های پوست و مو        مقطع: دستیاری تخصصی                   گروه آموزشي  پوست                 پست الكترونيك دانشجو: pardis_sasani@yahoo.com اساتيد راهنما و داور: استاد راهنما: خانم دکتر عابدینی                  اساتيد مشاور: آقای دکتر محمودی، خانم دکتر نسیمی                                                  اساتيد داور: خانم دکتر دانش پژوه، آقای دکتر صادقی نیا زمان دفاع :    روز : یکشنبه                         تاريخ: 14/9/1395                                ساعت: 12 مكان دفاع به آدرس: میدان وحدت اسلامی، بیمارستان پوست رازی، سالن آمفی تئاتر اطلاعات به زبان انگليسي     Title: A comparative study of the effect of intralesional verapamil with intralesional corticosteroids in the treatment of keloids and hypertrophic scar   Abstract: Background: Keloids and hypertrophic scars are due to overgrowth of dermal collagen following trauma to the skin that usually cause major physical, psychological and cosmetic problems. Methods: In this randomized double-blinded controlled trial, with a paired design, 50 patients with 2 or more keloids were studied. In control group (50 lesions), intralesional triamcinolone acetonide (40 mg/mL) was injected at three-week intervals for a total of 18 weeks. In the other group (50 lesions), lesions were treated by verapamil (2.5 mg/mL) with the same therapeutic sessions. Scar evaluation at each stage and at the end of 3 months follow up was done by serial photographic records as well as by Vancouver Scar Scale (VSS). Results: Mean zero VSS scores were achieved with only by triamcinolone in respect of scar height (w-15) and pliability (w-15). No therapeutic event (parameter =0) and even no significant improvement were seen in verapamil group. Conclusion: Our results did not support verapamil’s capability in treatment of keloid nor hypertrophic scars.   Keywords: Keywords: Keloid, Hypertrophic scars, Triamcinolone, Verapamil           فهرست منابع و ماخذ فارسي و لاتين: 1. 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