CO_(2)点阵激光联合放射治疗应用于瘢痕疙瘩的疗效与安全性  

Safety and efficacy of CO_(2) laser combined with radiotherapy in the treatment of keloids

作　　者：马倩玉 林翔[2] 陈宗安 谢春晖 王文波[1] 夏玲玲[1] 赵琼 高振[1] 武晓莉[1] MA Qianyu;LIN Xiang;CHEN Zongan;XIE Chunhui;WANG Wenbo;XIA Lingling;ZHAO Qiong;GAO Zhen;WU Xiaoli(Department of Plastic and Reconstructive Surgery,Shanghai Ninth People's Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200011,China;Department of Burn and Plastic Surgery,Heze Municipal Hospital,Heze 274031,China;Department of Burns Surgery,The First Hospital of Jilin University,Changchun 130021,China)

机构地区：[1]上海交通大学医学院附属第九人民医院整复外科,上海市200011 [2]菏泽市立医院烧伤整形科,山东省菏泽市274031 [3]吉林大学第一医院烧伤与皮肤创面修复外科,吉林省长春市130021

出　　处：《组织工程与重建外科》2021年第6期472-476,共5页Journal of Tissue Engineering and Reconstructive Surgery

摘　　要：目的探究CO_(2)点阵激光联合放射治疗(Laser combined with radiotherapy,LCR)应用于瘢痕疙瘩的临床疗效和安全性。方法采用回顾性研究及自身前后对照方法,选取2018年2月至2019年11月接受LCR治疗的瘢痕疙瘩患者60例。在LCR治疗中,患者均先行CO_(2)点阵激光治疗,激光治疗后24 h内进行首次放疗,激光治疗后第7天进行第二次放疗。治疗完成后6个月和12个月时随访。采用患者及观察者双向瘢痕评估量表(Patient and observer scar assessment scale,POSAS)评估治疗结果,并记录治疗及随访期间的不良反应及复发情况。结果患者治疗后12个月时的POSAS总分、患者总分及观察者总分均较治疗前显著降低。治疗后12个月的总复发率为13.3%,随访期间无严重不良反应发生。患者总体满意度为96.7%。结论CO_(2)点阵激光联合放射治疗瘢痕疙瘩具有良好的疗效及安全性,治疗过程高效简便,可临床推广应用。Objective To study the efficacy and safety of CO_(2) ablative laser combined with radiotherapy(LCR)in the treatment of keloids.Methods The retrospective before-after study in the same patient was conducted.From February 2018 to November 2019,60 patients with keloids underwent LCR treatment were retrospectively analyzed in this study.LCR treatment was composed of one round of fractional CO_(2) laser therapy and two rounds of radiotherapy.All the patients accepted laser therapy first and then the first pass of radiotherapy was initiated within 24 hours later.The second pass was performed on the 7 th day after laser therapy.Follow-up visits were conducted on the 6 th and 12 th month after treatment.Patient and observer scar assessment scale(POSAS)was used to evaluate the lesion.Data of recurrence,side effects and patient satisfaction were collected.Results The total scores of POSAS,patients'and observers'total scores at the 12-month follow-up after treatment were significantly lower than those before treatment.The total recurrence rate 12 months after treatment was 13.3%.There were no serious adverse reactions during follow-up.The overall satisfaction of patients was 96.7%.Conclusion LCR treatment for keloids has good curative effect and safety.The treatment process is efficient and simple,which can be popularized in clinical application.

关 键 词：瘢痕疙瘩 激光治疗 放射治疗 

分 类 号：R619+.6[医药卫生—外科学]