瘢痕疙瘩术后联合放疗的疗效观察及复发因素分析  

Observation of the efficacy of postoperative combined radiotherapy for keloid scars and analysis of recurrence factors

作　　者：李玉花 韦余宝 杨波 LI Yuhua;WEI Yubao;YANG Bo(Linyi Third People′s Hospital:Department of Oncology,Linyi Third People′s Hospital,Linyi,Shandong 276023,China;Linyi Third People′s Hospital:Department of Burn and Wound Repair,Linyi Third People′s Hospital,Linyi,Shandong 276023,China)

机构地区：[1]临沂市第三人民医院肿瘤科,山东临沂276023 [2]临沂市第三人民医院烧伤与创面修复科,山东临沂276023

出　　处：《现代医药卫生》2024年第9期1476-1479,共4页Journal of Modern Medicine & Health

基　　金：山东省医药卫生科技发展计划基金项目(202009031027)。

摘　　要：目的探讨瘢痕疙瘩手术联合放射治疗(放疗)的疗效及手术方式、放疗开始时间、放疗剂量、瘢痕疙瘩生长部位,以及是否应用医用硅酮凝胶敷料(巴诺克)对瘢痕疙瘩复发的影响。方法回顾性分析2020年1月至2021年7月该院收治的45例瘢痕疙瘩患者的临床资料,根据不同治疗方式分为A组(手术联合常规放疗,10例)、B组(手术联合大分割放疗,12例)、C组(单纯手术治疗,8例)和组D(手术联合巴诺克治疗,15例)。对4组患者的治疗方式、临床疗效及复发因素进行回顾性分析。结果A组患者中复发2例(20.00%),B组患者中复发1例(8.33%),C组患者中复发7例(87.50%),D组患者中复发13例(86.67%)。手术联合放疗的疗效明显优于术后未行放疗组,差异有统计学意义(P<0.05)。术后是否联合放疗是瘢痕疙瘩复发的主要影响因素。结论与非放疗比较,手术联合放疗可明显提高患者治愈率、降低复发率;术后是否联合放疗、瘢痕是否在关节活动部位是瘢痕疙瘩复发的高危因素。Objective To investigate the efficacy of keloid surgery combined with radiation therapy(radiotherapy)and the effects of surgical approach,the start time of radiotherapy,the dose of radiotherapy,the site of keloid growth,and whether or not to apply a medical silicone gel dressing(Barnes&Noble)on keloid recurrence.Methods A total of 45 patients with keloid who admitted to the hospital from January 2020 to July 2021 were retrospectively analyzed and divided into the group A(surgery combined with conventional radiotherapy,10 cases),the group B(surgery combined with macrodissected radiotherapy,12 cases),group C(surgery alone,eight cases),and group D(surgery combined with Barnes&Noble treatment,15 cases)according to the different treatment modalities.The treatment modalities,clinical efficacy and recurrence factors of the four groups were retrospectively analyzed.Results There were two cases of recurrence in patients in group A(20.00%),one case of recurrence in patients in group B(8.33%),seven cases of recurrence in patients in group C(87.50%),and 13 cases of recurrence in patients in group D(86.67%).The efficacy of surgery combined with radiotherapy was significantly better than that of the group without postoperative radiotherapy,and the difference was statistically significant(P<0.05).Whether or not postoperative combined radiotherapy was the main influencing factor of keloid recurrence.Conclusion Compared with the non-radiotherapy group,surgery combined with radiotherapy can significantly increase the cure rate and decrease the recurrence rate of patients;whether or not to combine radiotherapy after surgery,and whether or not the scar is in the joint mobility area are the high-risk factors for keloid recurrence.

关 键 词：瘢痕疙瘩 手术 放射治疗 复发 高危因素 

分 类 号：R619.6[医药卫生—外科学]