手外伤术后治疗瘢痕药物的研究进展

Professional English on Research Progress of Drugs for Scar Treatment after Hand Trauma Surgery

摘要: 手部作为执行精细动作与展现人体美学的关键器官，其外伤发生率在临床实践中始终居高不下。创面愈合后引发的病理性瘢痕，包括增生性瘢痕与瘢痕疙瘩，远非单纯的美观问题；它们所导致的关节挛缩、功能障碍、顽固性瘙痒及疼痛，严重损害患者的生理与心理健康。大量循证医学证据表明，拆线后早期是干预和阻断瘢痕增生病理进程的“黄金窗口期”。本文系统深入地阐述了手部创伤后瘢痕形成的细胞与分子生物学机制，并重点对比评析了当前主流的瘢痕防治药物(涵盖硅酮制剂、洋葱提取物、糖皮质激素、维A酸类、A型肉毒毒素及中药制剂等)的作用靶点、临床疗效、安全性及适用人群。此外，本文还全面探讨了压力治疗、激光、放射治疗等非药物策略及多种联合方案的协同效应，并对靶向治疗、基因技术与再生医学等未来方向进行了前瞻性展望，旨在为临床工作者构建系统化、个体化的瘢痕管理方案提供高级别的循证依据。

Abstract: The hand, being paramount for both function and aesthetics, is highly prone to trauma. The subsequent development of pathological scars, particularly hypertrophic scars and keloids, post wound healing, presents a significant clinical challenge that extends beyond cosmesis. These scars can lead to contractures, functional impairment, chronic pruritus, and pain, profoundly impacting a patient’s quality of life. Substantial evidence underscores the early post-suture removal phase as a critical therapeutic window for intervention. This review provides a comprehensive elucidation of the pathophysiological mechanisms underpinning scar formation following hand trauma. It delivers an in-depth, comparative evaluation of current pharmacological agents for scar prevention and treatment—including silicone-based products, onion extract preparations, corticosteroids, retinoids, botulinum toxin type A, and traditional Chinese medicine—focusing on their molecular mechanisms, clinical efficacy, safety profiles, and specific indications. Furthermore, it explores non-pharmacological modalities such as pressure therapy and laser intervention, alongside innovative combination strategies. Finally, the review offers insights into emerging frontiers like biological targeted therapy, gene editing, and regenerative medicine, aiming to equip clinicians with evidence-based knowledge for developing sophisticated, personalized scar management protocols.