手术切除联合放疗治疗耳廓瘢痕疙瘩的临床分析  

Surgical Resection Combined with Early Low-dose Radiotherapy in Treatment of Auricular Keloids

作　　者：唐菲 杨崇灵 曹伟 吕萍[2] 刘军[1] TANG Fei;YANG Chongling;CAO Wei;LV Ping;LIU Jun(Department of Otolaryngology-Head&Neck Surgery,the Sixth Medical Center of PLA General Hospital National Clinical Research Center for Otolaryngologic Diseases Department of Otolaryngology-Head&Neck Surgery,the Seventh Medical Center of PLA General Hospital,Beijing 100700,China;不详)

机构地区：[1]解放军总医院第六医学中心耳鼻咽喉头颈外科医学部,国家耳鼻咽喉疾病临床医学研究中心,解放军总医院第七医学中心耳鼻咽喉头颈外科,北京100700 [2]川北医学院川北医学院附属医院耳鼻咽喉头颈外科

出　　处：《中华耳科学杂志》2024年第6期941-945,共5页Chinese Journal of Otology

摘　　要：目的探究手术切除联合术后早期小剂量放疗对耳廓瘢痕疙瘩的治疗效果。方法回顾性分析2018年1月至2022年7月期间解放军总医院收治的49例(60耳)耳廓瘢痕疙瘩患者的病例资料,按照治疗方法不同分为三组,手术+放疗组采用手术切除联合小剂量放疗,共30例(37耳),手术+激素组采用手术切除联合局部注射激素,共6例(8耳),单纯手术组术后未进行辅助治疗,共13例(15耳)。对比三组临床疗效、温哥华瘢痕量表(vancouver scar scale,VSS)评分及术后复发率,并进行统计学分析。结果手术+放疗组、手术+激素组和单纯手术组有效率分别为96.67%、83.33%和46.15%,差异有统计学意义(P<0.05);治疗前三组VSS评分比较差异无统计学意义(P>0.05),治疗后6个月手术+放疗组、手术+激素组和单纯手术组VSS评分分别为3.00±1.15分、3.17±1.47分和5.77±2.83分,差异有统计学意义(P<0.05);手术+放疗组、手术+激素组和单纯手术组术后复发率分别为10.00%、33.33%和69.23%,差异有统计学意义(P<0.05)。结论手术彻底切除瘢痕组织联合术后早期小剂量放疗可有效减少瘢痕增生,降低复发率。Objective To report outcomes of surgical resection combined with low-dose radiotherapy for auricular keloids.Methods From January 2018 to July 2022,49 cases(60 ears)of auricular keloids were treated at the PLA General Hospital,involving surgical resection combined with low-dose radiotherapy(30 cases,37 ears),surgical resection combined with local glucocorticoid injection(6 cases,8 ears),and surgical resection alone(13 cases,15 ears).Clinical outcomes,Vancouver scar scale(VSS)scores before and 6 months after treatment,and recurrence were compared among the three treatment modalities.Results The rate of overall effectiveness was 96.67%for surgery combined with radiotherapy,83.33%for surgery combined with glucocorticoid and 46.15%for surgery alone(P<0.05).There was no significant difference in VSS scores among the three groups before treatment(P>0.05).The VSS score at 6 months after treatment was 3.00±1.15 for surgery combined with radiotherapy,3.17±1.47 for surgery combined with glucocorticoid and 5.77±2.83 for surgery alone(P<0.05).The rate of recurrence was 10.00%for surgery combined with radiotherapy,33.33%for surgery combined with glucocorticoid and 69.23%for surgery alone(P<0.05).Conclusions Complete resection of scar tissue combined with early postoperative low-dose radiotherapy can effectively reduce scar hyperplasia and recurrence.

关 键 词：耳廓瘢痕疙瘩 手术切除 放射治疗 糖皮质激素 疗效 

分 类 号：R764.9[医药卫生—耳鼻咽喉科]