自体瘢痕皮回植联合局部注射等治疗胸前巨大瘢痕疙瘩的疗效观察  

Excision of Keloids Followed by Autologous Skin Grafting and Intralesional Drug Injections in the Treatment of Huge Prethoracic Keloids

作　　者：郑秀芬 何仁亮 黄桃源 朱定衡 胡勇 王瑞华 汤红峰 ZHENG Xiufen;HE Renliang;HUANG Taoyuan;ZHU Dingheng;HU Yong;WANGRuihua;TANG Hongfeng(Department of Dermatology,Shunde Hospital of Southern Medical University,Foshan 528308 China;Department of Dermatological Surgery and Cutaneous Oncology,Dermatology Hospital of Southern Medical University,Guangzhou 510091,China)

机构地区：[1]南方医科大学顺德医院皮肤科,广东佛山528308 [2]南方医科大学皮肤病医院皮肤外科与皮肤肿瘤科,广东广州510091

出　　处：《中国皮肤性病学杂志》2021年第7期820-824,共5页The Chinese Journal of Dermatovenereology

摘　　要：目的回顾性分析自体瘢痕皮回植联合局部注射等综合治疗胸前巨大瘢痕疙瘩的临床疗效。方法对30例胸前巨大瘢痕疙瘩患者,行瘢痕疙瘩切除后自体瘢痕皮回植覆盖修复创面,配合局部注射等综合方法治疗,术后随访1年,评估瘢痕疙瘩复发和瘢痕形成情况。结果30例患者回植的瘢痕皮均成活。随访1年,3例瘢痕疙瘩所致的疼痛、瘙痒等症状消失,皮片始终平整且颜色与周围皮肤较回植前接近;21例于2个月后相继出现部分复发,配合局部注射(1~4次曲安奈德联合5-氟尿嘧啶)后瘢痕保持平整,瘙痒、疼痛基本消失。4例瘢痕复发≥70%面积,配合局部注射缓解,2例(6.67%)无效,有效率为80.00%。结论自体瘢痕皮回植术的优点是将瘢痕皮“变废为宝”,并避免在远处供区形成瘢痕疙瘩的危险,与局部注射等方法联合,为治疗胸前巨大瘢痕疙瘩的一种有效的办法。Objective Retrospective analysis of the clinical effectiveness of autologous skin graft combined with intralesional injection of triamcinolone acetonide combined with 5-fluorouracil(TAC+5FU)in the treatment of huge keloids on the chest.Methods Thirty patients with giant chest keloid were treated with autologous skin regeneration after scar removal followed by intralesional injections of TAC+5FU.Reconstructed defects were assessed for recurrence of keloids and scar appearance up to one year.Results Each patient had 100%viability of the autograft.During the one-year follow-up,three patients had no long-term complaints of pruritis or pains.The scars remained flat,and their color was similar to that of the surrounding skin before replantation.Another 21 cases were partially cured with a portion of scar hypertrophy two months post-surgery,and the symptoms gradually disappeared after one to four intralesional injections.In four cases,the area of scar recurrence was≥70%,and the symptoms were relieved after intralesional injections.Treatment of two cases(6.67%)was ineffective.The total effective rate was 80.00%.Conclusion The advantages of this procedure are the availability of skin and reduced keloid formation in a distant donor site.

关 键 词：瘢痕疙瘩 自体皮 瘢痕皮 手术切除 皮瓣移植 局部注射 

分 类 号：R739.2[医药卫生—肿瘤]