核素^(90)Sr-^(90)Y敷贴治疗瘢痕疙瘩治疗方案的疗效观察

Observation on Efficacy of Three Methods of Therapy for Cheloid with Nuclide^(90)Sr-^(90)Y Application

目的 :探讨核素 90 Sr- 90 Y敷贴治疗瘢痕疙瘩三种治疗方案的疗效。方法 :对 11例耳部瘢痕疙瘩患者按改良法 (每疗程分 3次治疗 )进行核素 90 Sr- 90 Y敷贴治疗。并以常规使用的多次法 (每疗程分 10次治疗 ) 10例 ,一次法 10例分别作为对照组。对三组分别定期随访 1a。结果 :改良法组治愈 7例 ,有效 4例 ,治愈率 6 3.6 % ;多次法组治愈 7例 ,有效 3例 ,治愈率 70 % ;一次法组治愈 4例 ,有效 4例 ,无效 2例 ,治愈率 40 %。经统计学处理 ,改良法组与多次法组比较 P>0 .0 5 ,两组疗效无显著差异 ,改良组与一次法组比较 P<0 .0 5 ,两组疗效有显著差异。结论 :多次法具有疗效高 ,皮肤放射反应小的优点 ,但存在治疗时间长患者不易坚持的缺点。一次法虽治疗时间短 ,但存在皮肤放射反应较大 ,不能投入有效的吸收剂量而影响治疗效果。改良法克服了以上方法的不足 ,既缩短了治疗时间 ,又不影响疗效 。

In this article we evaluated the effect of three methods of therapy for cheloid with nuclide 90Sr- 90Y application. A total of 31 cheloid patients were included in this study. Nuclide 90Sr- 90Y application therapy was performed with improvement method in 11 auri-cheloid patients. As for controls, the routine ten-session application therapy was performed in 10 patients and the routine one-session method in 10 patients. The three groups were followed up for one year respectively. The results of therapy were assessed as follows: with the improvement method, curative in 7, effective in 4, the cure rate being 63.6 %; with ten-session method, curative in 7, effective in 3, the cure rate being 70 %; with one-session method, curative in 4, effective in 4 and unchanged in 2, the cure rate being 40 %. A statistical comparison between the improvement group and the ten-session group is not significant in their curative effect (P>0.05). And between the improvement group and the one-session group, there is statistically significant difference with regard to their therapeutic results (P<0.05). In conclusion, the ten-session method has such advantages as high effectiveness and less skin radioreaction, with a disadvantage of long treatment course in which patients do not tend to persist. The one-session method, though having the advantage of short treatment course, is less effective due to insufficient absorption of effective dose by reason of heavy skin radioreaction. The improvement method has overcome the defects of the first two methods both by reducing the treatment course and by ensuring the effect, and it is worth making it a common practice in the clinic.