手术联合多种方法治疗耳部瘢痕的疗效对比研究  

Comparative study of surgical treatment combined with various methods for treatment of ear scar

作　　者：乔晓峰[1] 李昕[2] 

机构地区：[1]山西省人民医院耳鼻咽喉科,太原030012 [2]山西省儿童医院手术部

出　　处：《临床耳鼻咽喉头颈外科杂志》2017年第17期1341-1343,共3页Journal of Clinical Otorhinolaryngology Head And Neck Surgery

摘　　要：目的:评价耳部瘢痕手术切除联合术中糖皮质激素局部注射及术后浅层电子线照射治疗的临床效果,以期找到一套以外科手术为主的个性化综合治疗体系。方法:将160例耳部瘢痕患者分为单纯手术组、手术联合得宝松局部注射组、手术联合浅层电子线照射组及手术联合术中激素和术后浅层电子线照射组(三联疗法组),并随访1年。依据Darzi的瘢痕疙瘩疗效标准判断疗效,并进行统计学分析。结果:术后1年单纯手术组有效率为52.5%,手术联合得宝松局部注射组有效率为80.0%,手术联合浅层电子线照射组有效率为82.5%,三联疗法组有效率为97.5%。单纯手术组的疗效明显低于其他3组(P<0.01);三联疗法组的疗效优于手术联合浅层电子线照射组以及手术联合得宝松注射组,差异有统计学意义(P<0.05);而手术联合得宝松注射组与手术联合浅层电子线照射组相比,疗效差异无统计学意义(P>0.05)。结论:在耳部瘢痕治疗中,单纯手术切除疗效差,不推荐;三联疗法优于手术联合糖皮质激素局部注射和手术联合浅层电子线照射,应作为治疗首选;手术联合糖皮质激素局部注射和手术联合浅层电子线照射疗效总体满意,可以根据具体情况个性化使用。Objective：To evaluate the clinical effect of auricular keloids resection combined with local injection of glucocorticoid and superficial X-ray treatment in order to identify a surgery-based, personalized, comprehensive treatment system. Method：One hundred and sixty patients with auricular keloids were divided into four groups： surgery group, surgery combined with local injection of glucocorticoid group, surgery combined with superficial X- ray group and surgery combined with glucocorticoid and electron irradiation group（Triple therapy group）. These groups were followed up for one year. Based on Darzi＇s criterion of keloid curative effect, the effect was judged and analyzed statistically. Result：One year after operation, the effective rate of the surgery group was 52.5 %, that of the surgery combined with glucocorticoid injection group was 80.0%, that of the surgery combined with the su- perficial X-ray group was 82. 5%, and that of the triple therapy group was about 97.5%. The simple surgery group was significantly lower than the surgery combined with glucocorticoid injection group, the operation com- bined with superficial X-ray group and triple therapy group （P〈0.01）; the triple therapy group was better than the surgery combined with superficial X-ray group and surgery combined with glucocorticoid injection group, showing statistically significant differences （P〈0.05） ; There was no statistical difference （P〈0.05） between the surgery combined with glueocorticoid injection group and the surgery combined with superficial X-ray group. Con- clusion：In the auricular keloids treatment, surgical resection with a poor curative effect is not recommended l triple therapy, which is better surgery combined with glucocorticoid local injection and surgery combined with superficial X-ray, should be used as the first line treatment. The overall response rate of surgery combined with glucocorti- coid local injection and surgery combined with superficial X-ray is satisfactory. It should be indiv

关 键 词：耳部瘢痕 外科手术 放射治疗 得宝松 浅层电子线 

分 类 号：R764.9[医药卫生—耳鼻咽喉科]