头颈部瘢痕疙瘩的综合治疗

Curative effects of synthetic therapy for keloid in head and neck region

目的评价手术联合放射治疗及局部注射激素类抗瘢痕药物治疗头颈部瘢痕疙瘩的疗效。方法对35例头颈部瘢痕疙瘩采用手术切除直接缝合或邻位皮瓣修复术,术后24小时术野行放射治疗,每日1次,连续照射10次,每次剂量2 Gy,总剂量20 Gy,对有复发倾向者行局部注射激素类抗瘢痕药物。结果本组35例患者切口均Ⅰ期愈合,术后随访1～4年,治愈25例(71.43%),显效1 0例(28.57%),有效率1 00%。本组患者均未出现严重的与放射治疗有关的并发症。结论头颈部瘢痕疙瘩采用手术联合放射治疗及局部注射激素类抗瘢痕药物的综合治疗是较为有效的方法之一。

OBJECTIVE To evaluate the curative effects of surgery combined with early radiotherapy and local injection of hormonal anti-scarring drugs in the treatment of keloid in head and neck region. METHODS 35 patients with keloid were treated with surgery （~completely excised and sutured directly or treated with local skin flap） . Radiotherapy was applied within 24 hours after operation. A total dose of 20 Gy was administered in ten fractions of 2 Gy every day. Patients who had recurrences were treated with local injection of hormonal anti-scarring drugs. RESULTS After operation, all the wounds were healed by first intention. After 1-4 year follow-up, 25 cases （71.43%） were cured without relapse; 10 cases （28.57%） showed partial remission. The rate of therapeutic effect was 100%. CONCLUSION Surgical removal combined with local radiation and local injection of hormonal anti-scarring drugs are one of the effective methods in treatment with keloid in head and neck region.