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1、瘢痕内切除后即时放疗治疗瘢痕疙瘩临床研究[摘要]目的:探讨瘢痕内切除后即时放疗治疗瘢痕疙瘩的临床疗效。方法:自2002年2月~2007年6月对我科收治的18例瘢痕疙瘩患者行瘢痕内切除术,术后24h内辅以6MeV高能电子束(0射线)放射治疗,连续照射每天一次连续照射4〜6次,照射总剂量15〜20Gy。术后平均随访36月。结果:优良10例(55.6%),显效5例(27.8%),无效3例(16.7%),总有效率83.3%o3例伤口延迟愈合(16.7%),术后出现色素沉着3例(16.7%),毛细血管轻度扩张2例(11.1%),随访期内未发生如皮肤恶性肿瘤等并发症。结论:瘢痕内切除后即时放射
2、治疗,术后复发率低,是治疗瘢痕疙瘩较好的治疗手段。[关键词]瘢痕疙瘩;放射治疗;瘢痕内切除[中图分类号JR622[文献标识码]A[文章编号]1008-6455(2009)01-0005-03ClinicalanalysisofkeloidswithintralesionalexcisionandimmediatepostoperativeadjuvantradiotherapySHENHua,SHENZun-li,WANGYong-chun,HUANGYi-xiong,ZHANGZhao-feng,JIAWan-xin(DepartmentofPlasticSurgery,theF
3、irstAffiliatedHospitalofShanghaiJiaotongUniversity,Shanghai200080,China)Abstract:ObjectiveToevaluatethetreatmentresultsofkeloidswithintralesionalexcisionandimmediatepostoperativeadjuvantradiotherapyinthemanagementofkeloids.MethodsEighteenpatientswithacombinedtotalof21keloidsweretreatedwith6MeV
4、electronbeamradiotherapyaftersurgicalintralesionalexcisionofthekeloids.Allpatientsreceivedatotaldoseof15~20Gyon4~6consecutivedaysbeginningthedayofsurgery.Meandailyfractionsof300~400cGywereadministered・Thetimeintervalbetweenkeloidexcisionanddeliveryoffirstfractionofradiotherapywaslessthan24hina
5、llcase・Themedianfollow-upwas36months.ResultslOcaseswerenotedtohaveexcellentresultand5casesweregood,totaleffectiveratewas83.3%and3patientsofrecurreneewasobservedduringthisperiod,onlyafewadverseeffectssuchasdelayedwound-healingin3patients,hypopigmentationwasobservedin3patients(16.7%),andtelangie
6、ctasiasin2patients(11.1%).Noseverecomplicationsorsecondarymalignancieswereobserved.Conclusionslntralesionalexcisionofkeloidandpostoperativeelectronradiotherapyandiswelltoleratedandveryeffectiveinpreventingkeloidrecurrenee.Keywords:keloid;radiotherapy;intralesionalexcision瘢痕疙瘩是由于皮肤对创伤后炎症过度反应所致的
7、纤维组织增生性疾病。目前形成瘢痕疙瘩的病因尚不清楚。临床表现为局部突起持续性存在的瘢痕伴有奇痒、疼痛等不适,给患者带来痛苦和烦恼。本科对2002年2月~2007年6月收治的18例瘢痕疙瘩患者米用瘢痕内切除后即时放射治疗,取得较好疗效,现报道如下。1资料和方法1.1—般资料:本组18例21处病灶,其中男7例,女11例。年龄26-49岁,平均32.8岁。病灶位于胸前区7处,四肢6处,亥页颈部5处,耳垂及耳周3处。病灶面积从2cmx3cm~6cmx8cmo1.2治疗方法:所