CO2激光联合磷[^32p]酸钠盐敷贴治疗瘢痕疙瘩的疗效观察

Efficacy of CO2 laser combined with ^32P-patch contact brachyradiotherapy for the treatment of keloids

目的探讨CO2激光联合磷[^32P]酸钠盐敷贴治疗顽固性瘢痕疙瘩的效果。方法2001至2006年，对122例151个经过2种或2种以上方法治疗后复发的顽固性瘢痕疙瘩，采用下述方法：①连续波CO2激光去除增生性瘢痕组织，超脉冲CO2激光治疗新鲜肉芽组织；②磷[^32P]酸钠盐敷贴：创面愈合后，依据患者年龄、个体差异、身体状况，以及瘢痕厚度、大小和不同部位，给予磷[^32P]酸钠盐敷贴0．5—1MBQ／cm^2，时间为72～96h，每1～2个月1次，连续用2—3次。结果122例151个顽固性瘢痕疙瘩，显效为111个，有效为40个。不良反应包括色素沉着21处、色素脱失32处。经随访2-6年，无一例复发。结论CO2激光联合磷[^32P]酸钠盐敷贴治疗顽固性瘢痕疙瘩是一种较安全有效的方法。

Objective To investigate the efficacy of CO2 laser combined with ^32P -patch contact brachyradiotherapy for the treatment of keloids. Methods From 2001 to 2006, 121 cases with 151 keloids, which reoccurred after treatment with more than 2 methods, underwent continuous CO2 laser treatment to remove the hypertrophic scar tissue, following by ultra-pulse CO2 laser to treat the fresh granulation tissue. After wound healing,3^32P-patch contact brachyradiotherapy was used for the lesion, 0. 5- 1 MBQ/cm^2 for 72-96 hours, every 1-2 months. 2-3 treatment were applied. Results Among the 151 keloids, good result was achieved in 111 keloids, and effective result in 40 keloids. Adverse effect included hyperpigmentation in 21 lesions and hypopigmentation in 32 lesions. The patients were followed up for 2-6 years without relapse. Conclusion CO2 laser combined with ^32P-patch contact brachyradiotherapy is an effective and safe method for the treatment of recalcitrant keloids.