耳部瘢痕疙瘩综合治疗的临床分析

Clinical analysis of combined therapy for keloid in the region of the ear

目的评价耳部瘢痕疙瘩手术后联合放射治疗及局部注射激素类抗瘢痕药物治疗的临床效果。方法采用手术切除直接缝合或转移皮瓣修复术,术后1周内行放射治疗,每日1次,连续照射3次,每次剂量5Gy,总剂量15Gy。对有复发倾向者行局部注射激素类抗瘢痕药物,以曲安奈德40mg加2%利多卡因稀释一倍后瘢痕内注射,每周1次,视瘢痕消退情况逐渐撤药。结果本组10例患者,术后随访1.5～5.0年,治愈6例(60%),显效4例(40%),有效率100%。结论手术联合放射治疗及局部注射激素类抗瘢痕药物是治疗耳部瘢痕疙瘩的有效方法。

Objective To evaluate the clinical effects of surgery combined with early radiotherapy and local injection of hormonal anti - scarring drugs in the treatment of earlobe keloid. Methods All keloids were treated with surgery （completely excised and suutred directly or treated with local skin flap）. Radiotherapy was clone with in 7 days after operation. A total close of 15 Gy was administered in three fractions of 3 Gy every day. Patients who had recurrences were treated with local injection of hormonal anti - scarring drugs. Triamcinolone 40 mg diluted with 2 % lidocaine was injected into the scar tissue once a week. Administration of this drug was gradually tapered according to the reduction of the scar. Results After 1.5 - 5.0 years follow - up, 6 cases （60%） were cured without relapse; 4 eases （40%） showed partial remission. The rate of therapeutic effect was 100%. Conclusion Using surgery combined with early radiotherapy and local injection of hormonal anti - scar drugs in the treatment of earlobe keloid gives an improved therapeutic effect.