穿耳孔后耳部瘢痕疙瘩的综合治疗与效果评价  

Evaluation of Synthetic Therapy for Keloids in Aural Region after Pierced Ears

作　　者：罗志军[1] 黎洪棉[1] 王和庚[1] 徐昆明[1] 

机构地区：[1]中山大学附属中山医院整形美容烧伤科,广东中山528403

出　　处：《医学信息》2013年第5期59-60,共2页Journal of Medical Information

摘　　要：目的探讨和评价穿耳孔后耳部瘢痕疙瘩手术后联合放射治疗等综合治疗的临床效果。方法2005年8月～2012年8月收治63例（82处）耳部瘢痕疙瘩患者。男4例，女59例；年龄16～45岁。病程10个月～6年。瘢痕疙瘩范围O．5cm×0．5cm×0．3cm～4．0cm×4．0cm×2．0cm，形状呈圆球形或椭圆球形。根据瘢痕疙瘩不同大小和范围，选择不同手术方式，切除瘢痕并行缺损修复。术后24h内，高能电子柬放射治疗8次，每次3Gy．总剂量24Gy，对有复发倾向者，及时行“得宝松”lmg及2％利多卡因按2：1混合液局部瘢痕内注射3次，每2w1次。结果术后患者切口均I期愈合．皮瓣均成活。获随访la以上，均获临床治愈；4例（6处）于术后3～6个月有复发倾向，及时局部注射”得宝松”后未见复发。疗效标准判定治愈59例．显效4例。结论穿耳孔后后致耳部瘢痕疙瘩应尽早采用手术切除修复，结合早期放疗，可取得满意效果，是治疗的较好选择方案之一．Objective To investigate and evaluation the effectiveness of surgical removal combined with adjuvant therapy on the aural region keloid. Methods From August 2005 to August 2012, 63 patients （82 side ears） with keloid at the aural region were treated. There were 4 males and 59 females, aged 16 to 45 years. The course of disease ranged from 10 months to 6 years, the sizes of keloids ranged from 0.5cm×O.5cm×O.3cm to 4.0cm×4.0cm×2.0 cm with globular or ellipse. According to the different sizes and the range of keloids, different operations to remove the keloids and repair the defect tissue were chosen. Wounds were exposed to the electron beam at first 24 hours after operation, once on alternate days and at 3Gy each time for 8 times and total dose 24Gy. An immediate local injection for the keloid with hormones anti-scar drugs, which was a mixture of Betamethasone （Diprospan） and 2% Lidocaine with a proportion of 2：1, was given to the patients who had recurrence trend 3 times, every 3 weeks. Results After operation, all the wounds healed by first intention. And 37 cases （64 lateral ears） were followed up for 1 year, and all achieved clinical cure. Four cases （6 lateral ears） had the trend of recurrence 3-6 months after operation and were cured after the immediate local injection for the keloid with hormones anti-scar drugs. According to LIU Wenge＇s curative criterion, 59 cases were cured and 4 cases responded to treatment. Conclusion Surgical removal combined with local radiation and hormones infiltrated individually as early as possible can effectively treat aural region keloids after pierced ears. And it is an optimal method.

关 键 词：瘢痕疙瘩 耳 手术 放射治疗 综合治疗 

分 类 号：R764.8[医药卫生—耳鼻咽喉科]