Hyperbaric oxygen therapy improves the effect of keloid surgery and radiotherapy by reducing the recurrence rate

高压氧治疗降低瘢痕疙瘩切除联合放疗后的复发率（英文）

Objective： Keloids are exuberant cutaneous scars that form due to abnormal growth of fibrous tissue fol- lowing an injury. The primary aim of this study was to assess the efficacy and mechanism of hyperbaric oxygen therapy （HBOT） to reduce the keloid recurrence rate after surgical excision and radiotherapy. Methods： （1） A total of 240 patients were randomly divided into two groups. Patients in the HBOT group （O group） received HBOT after surgical excision and radiotherapy. Patients in the other group were treated with only surgical excision and radiotherapy （K group）. （2） Scar tissue from recurrent patients was collected after a second operation. Hematoxylin and eosin （H＆E） staining was used to observe keloid morphology. Certain inflammatory factors （interleukin-6 （IL-6）, hypoxia-inducible factor-1α （HIF-1α）, tumor necrosis factor-α （TNF-α）, nuclear factor KB （NF-κB）, and vascular endothelial growth factor （VEGF）） were measured using immunohistochemical staining. Results： （1） The recurrence rate of the O group （5.97%） was significantly lower than that of the K group （14.15%）, P〈0.05. Moreover, patients in the O group reported greater satisfaction than those in the K group （P〈0.05）. （2） Compared with the recurrent scar tissue of the K group, the expression levels of the inflammatory factors were lower in the recurrent scar tissue of the O group. Conclusions： Adjunctive HBOT effectively reduces the keloid recurrence rate after surgical excision and radiotherapy by improving the oxygen level of the tissue and alleviating the inflammatory process.

目的:研究高压氧治疗降低瘢痕疙瘩切除联合放疗后复发率的效果及作用机制。创新点:将高压氧治疗应用于瘢痕疙瘩的辅助治疗。方法:(1)将240例瘢痕疙瘩患者随机分成两组(高压氧治疗组和非高压氧治疗组),高压氧治疗组接受瘢痕疙瘩切除术、放疗及高压氧治疗;非高压氧治疗接受瘢痕疙瘩切除及放疗。(2)收集两组复发病人二次手术切下的瘢痕疙瘩标本及正常皮肤标本,通过免疫组化染色观察三组组织标本因子白细胞介质-6(IL-6)、缺氧诱导因子-1α(HIF-1α)、肿瘤坏死因子-α(TNF-α)、核因子-κB(NF-κB)和血管内皮生长因子(VEGF)的表达量。结论:高压氧治疗通过提高瘢痕疙瘩组织氧含量及减少炎症反应来降低瘢痕疙瘩切除联合放疗后的复发率。