持续塑形加压综合治疗耳郭瘢痕疙瘩的效果  

Effect of continuous shaping and compression in the comprehensive treatment of auricle keloids

作　　者：雷蓓蓓 张璐璐[1,2] 王璐[1,2] 张栋益[1,2,3] Lei Beibei;Zhang Lulu;Wang Lu;Zhang Dongyi(Department of Plastic and Cosmetic Surgery,Henan University People's Hospital,Zhengzhou 450003,China;Department of Plastic and Cosmetic Surgery,Henan Provincial People's Hospital,Zhengzhou 450003,China;Department of Plastic and Cosmetic Surgery,Zhengzhou University People's Hospital,Zhengzhou 450052,China)

机构地区：[1]河南大学人民医院整形美容外科,郑州450003 [2]河南省人民医院整形美容外科,郑州450003 [3]郑州大学人民医院整形美容外科,郑州450052

出　　处：《中华医学美学美容杂志》2022年第6期471-474,共4页Chinese Journal of Medical Aesthetics and Cosmetology

摘　　要：目的观察持续塑形加压综合治疗耳郭瘢痕疙瘩的效果。方法2018年6月至2020年4月,河南省人民医院整形美容外科收治耳郭瘢痕疙瘩患者40例(53耳),男7例、女33例;年龄17~45岁,平均25岁。根据治疗方式分为手术注射组20例(27耳)与手术注射加压组20例(26耳),连续随访>18个月,观察两组的临床疗效、耳郭形态满意度及感染和复发情况。结果手术注射加压组有效率(24耳,92.31%)高于手术注射组(16耳,59.26%),差异有统计学意义(χ^(2)=5.12,P<0.05)。两组患者治疗后6个月和12个月的温哥华瘢痕量表(VSS)评分均较治疗前明显下降,且手术注射加压组VSS评分低于手术注射组,差异有统计学意义(P<0.05)。手术注射加压组满意率(22耳,84.62%)高于手术注射组(13耳,48.15%),差异有统计学意义(χ^(2)=4.05,P<0.05)。手术注射加压组复发率较手术注射组明显降低,差异有统计学意义(χ^(2)=5.78,P<0.05)。两组患者治疗后感染率比较,差异无统计学意义(χ^(2)=0.001,P>0.05)。结论持续塑形加压综合治疗耳郭瘢痕疙瘩疗效显著,可降低复发率、维持耳郭形态、提高治疗满意度。Objective To observe the effect of continuous shaping and compression in the comprehensive treatment of auricle keloids.Methods From June 2018 to April 2020,40 patients with auricular keloids(53 ears)admitted to the Plastic Surgery Department of Henan Provincial People's Hospital were divided into surgical injection group(20 cases,27 ears)and surgical injection compression group(20 cases,26 ears)according to the treatment method.The patients were followed up for more than 18 months continuously;the clinical efficacy,satisfaction with auricle morphology,and the occurrence of infection and recurrence were observed in the two groups.Results The effective rate of surgical injection compression group(24 ears,92.31%)was higher than that of surgical injection group(16 ears,59.26%),and the difference was statistically significant(χ^(2)=5.121,P<0.05).The Vancouver scar scale(VSS)scores of the two groups at 6 months and 12 months after treatment were significantly lower than that before treatment,and the VSS score of the surgical injection compression group was lower than that of the surgical injection group,the difference was also statistically significant(P<0.05).The satisfactory rate of the surgical injection compression group(22 ears,84.62%)was higher than that of the surgical injection group(13 ears,48.15%),and the difference was statistically significant(χ^(2)=4.048,P<0.05).The recurrence rate of the surgical injection compression group was significantly lower than that of the surgical injection group(χ^(2)=5.779,P<0.05);there was no significant difference in the infection rate between the two groups of patients after treatment(χ^(2)=0.001,P>0.05).Conclusions Surgical resection of auricle keloids combined with local injection of corticosteroids and local shaping and compression can significantly improve the clinical efficacy,maintain the shape of the auricle,and the therapeutic effect is satisfactory.

关 键 词：耳郭 瘢痕疙瘩 手术切除 糖皮质激素 塑形加压 

分 类 号：R764.9[医药卫生—耳鼻咽喉科]