氟尿嘧啶联合电子线束照射治疗耳部瘢痕疙瘩疗效观察

Effect of the joint application of 5-fluorouracil and electronic wiring harness radiation on auricle keloid

目的观察应用氟尿嘧啶和糖皮质激素联合电子线束照射治疗耳部瘢痕疙瘩的治疗效果及安全性。方法 87例123个耳部瘢痕疙瘩均行手术切除,切除前瘢痕内注射用质量分数2%利多卡因注射液将氟尿嘧啶稀释至2～4g/L的混合液体0.6mL,可根据瘢痕疙瘩大小加入糖皮质激素曲安奈德2～20mg,注射总量<20mg/次;于术后24h行手术区电子加速器电子线束照射治疗。结果 87例患者均于手术后9～14d拆除缝线,无切口裂开;治疗后随访3～36个月,83例116个瘢痕疙瘩切口缝线瘢痕呈淡白色线状,无高起于皮缘,瘙痒、刺痛等症状消失,4例7个瘢痕疙瘩切口缝线处近期出现红斑,并伴有轻微瘙痒、刺痛,间断行红斑内曲安奈德封闭2～3次后症状消失;所有患者无不良反应及复发发生。结论手术切除联合术中氟尿嘧啶及糖皮质激素局部应用、术后早期进行电子线束照射治疗瘢痕疙瘩效果明显,复发率低,无明显不良反应。

Objective To observe the effect and safety of 5 fluorouracil （5-FU） and glucocorticoids combined with electronic wiring harness radiation on auricle keloid. Methods Eighty-seven patients （123 auricle keloids） underwent surgical resection after 0.6 mL 5-FU diluted by 2% lidocaine to 2 to 4 mg/mL was injected into the keloids, meanwhile, 2 to 20 mg triamcinolone acetonide was injected into the keloids according to the size of the keloids. Electronic wiring harness radiation was performed on the surgical area 24 hours after surgery. Results The stitches were removed 9 to 14 days after operation, with no disruption of wound. After 3 to 36 months of treatment, the incision scars were as like white lines with no knurls in 83 patients （116 keloids）, itching or twinge, and 4 patients （7 keloids） were found erythemas around the keloid incision complicated with itching and twinge which disappeared after twice to 3 times of triameinolone acetonide injection into the erythemas. There were no adverse reactions or relapse. Conclusion The joint application of 5-FU and glueoeorticoids during operation and electronic wiring harness radiation can effectively treat auricle keloid with low relapse rate and no adverse reaction.