术后早期放疗联合5-Fu和糖皮质激素注射治疗预防瘢痕疙瘩复发的疗效观察

The research of prevent recurrence combine with 5-fluorouracil and corticosteroid injections after excision keloid and early radiotherapy

目的：寻求瘢痕疙瘩综合治疗后预防复发的理想措施。方法145例瘢痕疙瘩，均采用瘢痕疙瘩切除减张缝合，术后早期放射治疗，放疗结束后每周随访1次，随访半年。对其中37例有复发倾向者（切口潮红、隆起高出周边皮肤1 mm）采取干预措施，用低浓度5-Fu、糖皮质激素和利多卡因混合液（0．6 mL 5-Fu ＋去炎舒松＋2％利多卡因1 mL），沿线状瘢痕内注射，每月1次，共4～6次。结果37例有复发倾向者，经局部注射低浓度5-Fu和糖皮质激素混合液4～6次后红色逐渐消退，瘢痕隆起得到控制。结论瘢痕疙瘩综合治疗后半年内需积极随访观察，对有复发倾向者早期注射低浓度5-Fu与糖皮质激素混合液，对预防复发有重要的意义。

Objective To seek the ideal measures after the keloid treatment to prevent recurrence .Methods 145 cases of keloid problems have adopted keloid excision and relaxation suture ,early radiotherapy after the operation ,then follow-up once a week for half a year . Interventions were taken in 37 cases in which patients had a relapse tendency （sacr show red,higher than the edge of the skin 1mm）,through injecting the mixture with low dose 5-fluorouracil,glucocorticoid and lidocaine （0.6mL 5-fluorouracil ＋triamcinolone acetonide ＋2%1mL lidocaine） along the line-shape scars,once a month,4~6 times in total.Results 37 cases with relapse tendency have been controled by in-jecting low dose 5-fluorouracil hormone mixture 4~6 times.Conclusion Active follow-up and observation is necessary during the first 6 months after the comprehensive treatment of keloid .It is of importance for preventing relapse by early injection of low dose 5-FU and glucocor-ticoids mixture in patients with the tendency .