手术联合平阳霉素和曲安奈德治疗胸部瘢痕疙瘩  

Treatment of chest keloid by surgical excision combined with Pingyangmycin and Triamcinolone acetonide

作　　者：矫立仁[1,2] 乔锋丽[1,2] 谢有富[1,2] 童仁联[1,2] 

机构地区：[1]暨南大学医学院第四附属医院 [2]广州市红十字会医院烧伤整形科,广东广州510220

出　　处：《中国美容医学》2013年第12期1260-1263,共4页Chinese Journal of Aesthetic Medicine

摘　　要：目的:探讨能否通过手术切除联合使用平阳霉素和曲安奈德局部注射的方法达到增加手术治疗胸部瘢痕疙瘩的有效率以及显著降低胸部瘢痕疙瘩手术后复发率的目的。方法:37例患者,共计52个胸部瘢痕疙瘩,其中35个瘢痕疙瘩位于胸骨柄处,17个瘢痕疙瘩位于胸骨柄上下方及左右。病史0.5～10年。34例患者有明确胸部抓挠史。术前先于手术切口注射0.25mg/ml的平阳霉素与20mg曲安奈德混合液,然后手术切除胸部瘢痕疙瘩,恢复胸部皮肤平整的外观。手术后3～4周开始于手术切口愈合处再次注射0.25mg/ml的平阳霉素与20mg曲安奈德混合液,每4周复查及必要时注射一次,如果瘢痕稳定无复发,可以每2月复查及必要时注射一次。如果不需药物治疗半年以上无复发视为治愈,如果上次注射半年内需要再次注射者为有效。结果:2009年5月～2012年5月,采用上述手术方法共治疗胸部瘢痕疙瘩患者37例,手术后注射治疗时间为2～5个月(平均3个月),不需药物治疗随访期3～24个月(平均10个月)。治愈32例(86.5%),有效5例(13.5%),总有效率100%。结论:手术切除联合局部注射平阳霉素和曲安奈德混合液是治疗胸部瘢痕疙瘩的有效方法。Objective To investigate whether intralesional injection of Pingyangmycin and Triamcinolone acetonide can efficiently and notably increase the effective rate and decrease the recurrence rate of surgically excised chest keloid. Methods Thirty-seven patients with fifty-two total chest keloids were studied. Among them,thirty-five chest keloids were located on the sternal manubrium of sternum,seventeen chest keloids were located beneath and around.The disease history was 0.5 ～10 years,and 34 patients with chest scratching history. Before the operation inject Pingyangmycin （0.25mg/ ml） and Triamcinolone acetonide （20mg） mixed liquid in the incision,then excision the chest keloid, recover the chest skin smooth appearance.3~4 weeks after the operation, inject Pingyangmycin（0.25mg/ml） and triamcinolone acetonide（20mg） mixed liquid in the healing place of incision again,every 4 weeks to review and inject if necessary. If the keloid was stable without recurrence,then very 2 months to review and inject when it is necessary. If it is unnecessary for medication for more than half a year without recurrence it is cure, it is effective if the last injection was within half year and it needs to inject again. Results From May 2009 to May 2012, adopting the above operation method in treatment of 37 patients with chest keloid,the therapeutic period was 2～5 months （ average 3 months）,the patients＇ follow-ups were 3-24 months （ average 10 months）after withdrawing drug injection.32 cases were cured （86.5%）,effective in 5 cases（13.5%）,The total effective rate was 100%. Conclusion Surgical removal of chest keloid combined with local injection of Pingyangmycin and Triamcinolone acetonide mixed liquid is an effective method to treat chest keloid.

关 键 词：胸部 瘢痕疙瘩 平阳霉素 曲安奈德 

分 类 号：R619.6[医药卫生—外科学]