^90Sr-^90Y敷贴与联合瘢痕内切除术治疗大面积病理性瘢痕的疗效  

The clinical value of scar endo-ectomy combined ^90Sr-^90Y applicator brachytherapy for large pathological scar

作　　者：代学之[1] 李现军[1] 赵志华[1] 冯志徐[1] 李凤岐[1] 王燕华[2] 

机构地区：[1]潍坊医学院附属潍坊市人民医院核医学科,261041 [2]潍坊医学院附属潍坊市人民医院整形美容科,261041

出　　处：《中华核医学杂志》2009年第6期414-416,共3页Chinese Journal of Nuclear Medicine

摘　　要：目的观察对比单纯^90Sr-^90Y敷贴和瘢痕内切除术后^90Sr-^90Y敷贴治疗大面积病理性瘢痕的疗效。方法选取临床确诊的大面积病理性瘢痕患者158例，共196块病理性瘢痕，按瘢痕厚度分为A、B、C 3组，每组患者再采用简单随机法分为两部分，分别接受单纯^90Sr-^90Y敷贴治疗（102块）和瘢痕内切除术并^90Sr-^90Y敷贴治疗（94块），治疗结束后2年评价疗效，行Ridit分析。结果瘢痕内切除术并^90Sr-^90Y敷贴的疗效明显优于单纯^90Sr-^90Y敷贴治疗（R=0．428和0．578，F=92．6，P〈0．01），前者疗效不受瘢痕厚度的影响，后者疗效则明显受瘢痕厚度影响。结论对于瘢痕表面积和厚度较大的病理性瘢痕患者。宜采用瘢痕内切除术并^90Sr-^90Y敷贴治疗。Objective Pathological scars including hypertrophic scars and keloids were the results of excessive fibroblast proliferation and abundant collagen deposition. The aim of this study was to investigate the value of scar endo-ectomy combined ^90Sr-^90Y applicator brachytherapy for large pathological scar. Methods A total of 158 large area pathological scar patients with 196 pieces of scars were divided into 3 groups. There were A, B and C, based on the thickness of pathological scar. Of these three groups, they were randomly divided into two subgroups. One was treated by ^90Sr-^90Y applicator brachytherapy alone （ n = 102） and the other （n = 94） was treated by endo-ectomy combined ^90Sr-^90Y applicator brachytherapy. All had clinical follow-up for at least 2 years to monitor the therapeutic outcomes. Results were analyzed by reference identical unit （Ridit）. Results A significant better outcome was observed in patients with endo-ectomy combined ^90Sr-^90Y applicator brachytherapy than with ^90Sr-^90Y applicator brachytherapy alone （R = 0. 428 and 0.578, F = 92.6, P 〈 0.01 ）. Thickness of pathological scars controlled the therapeutic effects for the later treatment but the former. Conclusion As to the scars with large area and thickness, scar endo-ectomy combined ^90Sr-^90Y applicator brachytherapy was recommended.

关 键 词：瘢痕 锶放射性同位素 钇放射性同位素 近距离放射疗法 

分 类 号：R686[医药卫生—骨科学]