瘢痕内切除后即时放疗治疗瘢痕疙瘩临床分析

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1、瘢痕内切除后即时放疗治疗瘢痕疙瘩临床分析瘢痕内切除后即时放疗治疗瘢痕疙瘩临床分析［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(B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15~20Gyo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%。3例伤口延迟愈合(16.7%),术后出现色素沉着3例

2、(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］R622［文献标识码］A［文章编号11008-6455(2009)01-0005-03ClinicalanalysisofkeloidswithintralesionalexcisionandimmediatepostoperativeadjuvantradiotherapySHENHua,

3、SHENZun-li,WANGYong-chun,HUANGYi-xiong,ZHANGZhao-feng,JIAWan~xin(DepartmentofPlasticSurgery,theFirstAffiliatedHospitalofShanghaiJiaotongUniversity,Shanghai200080,China)Abstract:0bjectiveToevaluatethetreatmentresultsofkeloidswithintralesionalexcisionandimme

4、diatepostoperativeadjuvantradiotherapyinthemanagementofkeloids.MethodsEighteenpatientswithacombinedtotalof21keloidsweretreatedwith6MeVelectronbeamradiotherapyaftersurgicalintralesionalexcisionofthekeloids・Allpatientsreceivedatotaldoseof15〜20Gyon4〜6consecut

5、ivedaysbeginningthedayofsurgery.Meandailyfractionsof300~400cGywereadministered・Thetimeintervalbetweenkeloidexcisionanddeliveryoffirstfractionofradiotherapywaslessthan24hinallcase・Themedianfollow-upwas36months.ResultslOcaseswerenotedtohaveexcellentresultand

6、5casesweregood,totaleffectiveratewas83.3%and3patientsofrecurrencewasobservedduringthisperiod,onlyafewadverseeffectssuchasdelayedwound-healingin3patients,hypopigmentationwasobservedin3patients(16・7%),andtelangiectasiasin2patients(11.1%).Noseverecomplication

7、sorsecondarymalignancieswereobserved・Conclusionslnlralesionalexcisionofkeloidandpostoperativeelectronradiotherapyandiswelltoleratedandveryeffectiveinpreventingkeloidrecurrence・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纤维组织增生性疾

8、病。目前形成瘢痕疙瘩的病因尚不清逵。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，给患者带來痛苦和烦恼。木科对2002年2月〜2007年6月收治的18例瘢痕疙瘩患者采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，埶颈部5处，耳垂及耳周3处。病灶面积从2cmX3c