单纯^(90)Sr-^(90)Y敷贴治疗瘢痕疙瘩的满意度报告及疗效分析

Patients' subjective assessment and clinical effect analysis of ^(90)Sr-^(90)Y brachytherapy to keloids

选取2005年9月–2009年11月在我院接受单纯90Sr-90Y多次小吸收剂量法敷贴治疗(5 Gy/次、1次/d、5次/1个疗程,治疗1–3个疗程)且瘢痕疙瘩厚度≤0.6 cm的107例病人,12个月后进行疗效满意度问卷调查,采用卡方检验比较性别及复发对疗效的影响,并记录辐射反应,进行疗效分析。结果显示,治疗方法对患者瘢痕相关症状(疼痛及瘙痒)的改善度为65%,外观满意度为71%,其中瘢痕疙瘩位于耳部及会阴的患者对治疗效果满意度最高,症状改善度和外观满意度均为100%;男性和女性在症状及外观方面的满意度无明显差别;复发患者的症状改善度低于未复发患者(P<0.05),且复发率与瘢痕厚度有关(P<0.05);复发并不影响患者对外观的满意度(P>0.05);不良反应包括轻度毛细血管增生(24%)、色素沉着(43%)、色素减退(33%),程度均为1–2级,无全身不良反应。表明厚度≤0.6 cm的瘢痕疙瘩患者接受单纯90Sr-90Y敷贴治疗,其症状改善度及外观满意度均良好,厚度越薄复发率越低,且不良反应越轻。

From September 2005 to November 2009,107 cases of keloids were treated by using 90Sr-90Y brachytherapy（25 Gy in 5 daily 5-Gy fractions,for 1–3 courses）.No keloids were thicker than 6 mm.Questionnaires were developed to find assessment of the patients 12 months after the treatment.And χ2-test was used to tell the results differences according to the gender and recurrences.The radiation side effects were also recorded.The results showed that 65% patients considered the therapeutic outcome to be excellent or good,and 71% patients considered the cosmetic outcome to be excellent or good.Patients with keloids on ear or perineal were greatly satisfied with the outcome（both the therapeutic and cosmetic outcomes were 100%）.The patients＇ assessment had no significant difference in gender.And patients without recurrence enjoyed the relief from former keloid-caused symptoms compared to the patients with recurrence（P0.05）.The recurrence rate could be related to the keloid thickness（P0.05）.The recurrence did not have an influence on assessment in cosmetic outcome（P0.05）.The radiation side effects include telangiectasias（24%）,hyperpigmentation（43%） and depigmentation（33%）,but none of them was wild.No patients were found to get systemic adverse reactions.90Sr-90Y brachytherapy is a good method to treat patients with keloides of less than 6 mm in thickness.The therapeutic and cosmetic outcomes are acceptable,and 90Sr-90Y brachytherapy is a good choose for the patients who cannot tolerate the pain of operations or injections.