三种方法治疗瘢痕疙瘩的临床疗效观察

Clinical Evaluation of three Methods in the Treatment of Keloid

目的:比较分析手术联合90Sr-90Y敷贴、手术联合糖皮质激素注射和局部糖皮质激素注射三种方法治疗瘢痕疙瘩的临床疗效。方法:患者分为A、B、C三组,A组行手术联合90Sr-90Y敷贴治疗:手术切除病灶,术后予90Sr-90Y敷贴治疗,每疗程剂量900cGy,小剂量分次,100～200cGy/次,隔日一次,每5次为一疗程,共2～3个疗程。B组行手术联合糖皮质激素注射治疗:手术切除病灶,术中注射醋酸曲安奈德注射液,术后每两周1次,连续2～4月。C组:皮损内注射醋酸曲安奈德注射液,每两周1次,连续3～6月。结果:A、B、C三组总有效率分别为97%,80%和53%。A与B组比较无显著差异(P>0.05)。A、B组分别与C组间比较均有显著性差异(P<0.05)。结论:A、B组两种综合治疗方法均较C组单一治疗疗效更为满意。

Objective To evaluate the effect of three methods of treatment of keloids： excision combined with postoperative radiation, excision combined with intralesional injection of steroid and intralesional injection of steroid. Methods Patients with keloids were divided into groupA, B and C. In group A, keloids were removed by operation, followed by 90Sr-90Y irradiation of total doses of 900 cGy, 100-200 cGy of which was applied every other day 5 times a couse and 2-3 courses would be required to be cured. In group B, patients were treated with intralesional injection of 40 mg triamcinolone during and after operation excision, which was repeated once 2 weeks, 4-8 times in total. Patients of group C were treated with intralesional injection of single 40mg triamcinolone every 2 weeks, 8-12 times in total. Results After respective treatment, all patients were followed up for 24 months. The overall efficacy was 0.83%, 0.80%, and 0.53% in group A, B and C respectively. There was significant difference between group A and C （P〈0.05）, as is between group B and C. Conclusion It was concluded that the effect of the combined therapy is more satisfactory than that of a single approach.