瘢痕内切除后即时放疗治疗瘢痕疙瘩临床分析  

Clinical analysis of keloids with intralesional excision and immediate postoperative adjuvant radiotherapy

作　　者：沈华[1] 沈尊理[1] 王永春[1] 黄一雄[1] 张兆峰[1] 贾万新[1] 

机构地区：[1]上海交通大学附属上海市第一人民医院整形科,上海200080

出　　处：《中国美容医学》2009年第1期5-7,共3页Chinese Journal of Aesthetic Medicine

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(β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%。3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治疗,术后复发率低,是治疗瘢痕疙瘩较好的治疗手段。Objective To evaluate the treatment results of keloids with intralesional excision and immediate postoperative adjuvant radiotherapy in the management of keloids. Methods Eighteen patients with a combined total of 21 keloids were treated with 6 MeV electron beam radiotherapy after surgical intralesional excision of the keloids. All patients received a total dose of 15-20Gy on 4-6 consecutive days beginning the day of surgery, Mean daily fractions of 300-400cGy were administered .The time interval between keloid excision and delivery of first fraction of radiotherapy was less than 24h in all case. The median follow-up was 36months. Results 10 cases were noted to have excellent result and 5 cases were good,total effective rate was 83.3% and 3 patients of recurrence was observed during this period, only a few adverse effects such as delayed wound-healing in 3 patients, hypopigmentation was observed in 3 patients （16.7%）, and telangiectasias in 2 patients （11.1%）. No severe complications or secondary malignancies were observed. Conclusions Intralesional excision of keloid and postoperative electron radiotherapy and is well tolerated and very effective in preventing keloid recurrence.

关 键 词：瘢痕疙瘩 放射治疗 瘢痕内切除 

分 类 号：R622[医药卫生—整形外科]