瘢痕疙瘩综合治疗的临床疗效探讨

Clincal Results of Combination Therapy for Keloid Patients

目的:探讨单纯放射治疗、手术加放射治疗瘢痕疙瘩的临床疗效。方法:回顾性分析直线加速器(6MeV)电子束放射治疗104例瘢痕疙瘩,其中单纯放疗50例,手术切除后放疗54例。照射剂量14-16 Gy 44例,16-20 Gy 60例,每次2 Gy,共1．5-2周。术后放疗在24 h内开始30例,拆线后开始24例。结果:(1)单纯放疗与手术后放疗比较:治愈率分别为44％和55．6％,有效率分别为66％和83．5％,两组比较有显著差异(P<0．05)。(2)术后24 h内放疗与拆线后放疗比较:治愈率分别为83．3％和41．7％,有效率分别为96．7％和62．5％,两组比较有显著差异(P<0．05)。(3)放疗剂量为Dt =14-16 Gy和Dt=16-20 Gy的治愈率分别为45．4％和52．7％,有效率均为75％,两组比较无显著差异(P>0．05)。结论:术后放疗是治疗瘢痕疙瘩的有效方法,尤其是术后24 h内放疗效果好于拆线后放疗。

Objective：To study the efficaey of keloid with radiotherapy only and postoperative radiation therapics treatment. Methods ： 104 patients with keloid patients were treated with accelerator of 6MeV-β ray, the total doses of radiation were 14-20 Gy,2 Gy one time,5 times one week 30 cases were managed by radiotherapy in while 24 h after operation,24 cases were not managed until stitches. Results： （1）The effective rate of radiotherapy was 60 %, the postoperative radiotherapy was 83.5 %, the latter was significantly higher than the former（P〈0. 05）. （2）The effective rate of radiotherapy in 24 h after operation was96. 7% ,after stitches was 62.5% ,the former was significantly higher than the latter（P〈0. 05）. （3）The doses of radiation between 14- 16 Gy was 75% ,the same as the doses between 16-20 Gy,there was no significant differences （P〉0. 05）. Conclusions ： Postoperative radiation therapy has better curative effect in keloid treatment,and it is better to be performed with 24 h after operation.