74例瘢痕疙瘩疗效分析及超声在瘢痕疙瘩治疗中的监测作用  

Curative effect analysis of 74 keloid cases and the role of high-frequency ultrasound in the lesions observation

作　　者：张婧秋 杨淑霞[1] 涂平[1] 刘凌[2] 李航[1] 

机构地区：[1]北京大学第一医院皮肤性病科,北京100034 [2]北京大学第一医院放射治疗科

出　　处：《实用皮肤病学杂志》2017年第3期136-141,共6页Journal of Practical Dermatology

摘　　要：目的分析瘢痕疙瘩的疗效与其临床特点及治疗方法的相关性,初步探索高频超声在瘢痕疙瘩治疗过程中的监测作用。方法对2013年1月—2015年12月在北京大学第一医院皮肤性病科接受以手术为主综合治疗的瘢痕疙瘩74例患者,分别就其临床特点、治疗方法与疗效进行回顾性统计分析,以及使用高频超声监测瘢痕的治疗过程。结果耳部与胸背部瘢痕疙瘩,单发与多发瘢痕疙瘩,不同大小瘢痕疙瘩,无自觉症状与有疼痛和瘙痒症状瘢痕疙瘩,既往曾接受手术治疗与曾接受皮损内糖皮质激素注射者的瘢痕疙瘩患者在治愈率方面有显著性差异(P<0.05)。一次性切除与分次切除治疗总有效率及治愈率有显著性差异(P<0.05),术后联合放射治疗与联合皮损内糖皮质激素注射治愈率有显著性差异(P<0.05)。高频超声可用于监测药物注射层次,还可以通过瘢痕超声图像特征及皮损与周围正常皮肤厚度的比值监测疗效。结论瘢痕疙瘩疗效与其临床特点及治疗方法有关。高频超声可以作为瘢痕疙瘩治疗及随访过程中的监测工具。Objective To evaluate the association between the clinical characteristics, the way of treatment and the curative effect of keloid, and explore the role of high-frequency ultrasound in the observation of keloid during the treatment. Methods A retrospective study was carried out to analyze the clinical features, therapies and the curative effect of 74 patients with keloid who had been treated by therapies including excision in the Department of Dermatology and Venerology in Peking University First Hospital from January 2013 to December 2015, during the treatment, high-frequency ultrasound was used to assess the state of the keloid. Results There were significant differences in the cure rate between ear keloids and those on the chest and back, single-keloid and multiple-keloids, small keloids and large keloids, patients who had been treated with surgical excision and corticosteroid injections in the past time, and patients with or without pain and pruritus（P0.05）. There were significant differences in both the effective rate and cure effect between one-time excision and fractional resection（P0.05）. There was significant difference in the cure rate between adjuvant postoperative radiotherapy and intralesional corticosteroid injections（P0.05）. High-frequency ultrasound could be used to monitor the depth of intralesional injection, and evaluate the effectiveness by comparing the Hypertrophic index and characteristics of images before and after the treatment.Conclusion The curative effect of keloid is related to its clinical features and treatment methods. High-frequency ultrasound can be used as a monitoring tool in scar treatment and follow-up.

关 键 词：瘢痕疙瘩 手术 放射治疗 皮损内注射 高频超声 

分 类 号：R622[医药卫生—整形外科]