^90Sr同位素动态治疗在病理性瘢痕防治中的应用

Therapeutic effect of ^90Sr dynamic therapy in the treatment of pathological scar .

目的 探讨手术切除联合^90Sr动态治疗病理性瘢痕的效果.方法 2010年6月至2014年6月,对323例病理性瘢痕患者,于手术切除术后,根据瘢痕的生长特征设定初步治疗方案,根据治疗进展行^90Sr同位素动态治疗,并与采用传统方案治疗的252例患者（2006年6月至2010年5月）进行比较,包括治疗效果及并发症等.使用SPSS 17.0对数据进行统计分析,组间比较采用卡方检验,治疗2年后对2组瘢痕温哥华评分采用单因素方差进行分析,P＜ 0.05为差异有统计学意义.结果 动态治疗组增生期吸收率为（4.32±0.00） cGy.s^-1.cm^-2,高于传统治疗组的（3.24±0.00） cGy.s^-1.cm^-2（F=1.742,P=0.000）.治疗后2年,动态治疗组评分为（2.94±1.22）分,明显低于传统治疗组的（4.21±1.68）分（F=93.841,P=0.000）;动态治疗组并发症发生率和复发率分别为0.9％ （3/323）和0.6％（2/323）,传统治疗组分别为11.1％ （28/252）和9.5％ （24/252）,两者分别比较差异均具有统计学意义（χ^2=457.69、P=0.000,χ^2=457.70、P=0.000）.结论 手术联合^90Sr同位素可有效治疗病理性瘢痕,但^90Sr同位素治疗没有绝对一致的治疗方案,须根据患者个性化特征进行动态治疗.

Objective To study the therapeutic effect of surgery combined with 90Sr dynamic therapy used in pathological scar.Methods 323 cases of pathological scar were treated with 90St dynamic therapy after surgery from June 2010 to June 2014.Initial treatment regimen was made according to the growth characteristics of pathological scar.Then adjusting the treatment programs according to the treatment response.The treatment effect and complications were compared between the new treatment regimen and traditional regimen used in 252 patients （June 2006 to May 2010）.SPSS 17.0 was used for statistical analysis of data.Chi-square test was used for comparison of the differences between groups.The scars Vancouver scores were analyzed by one-way ANOVA two years after treatment.P 〈 0.05 was considered statistically significant.Results The absorption rate in the proliferative phase of the dynamic treatment group was （4.32 ±0.00） cGy.s^-1.cm^-2,which was higher than that in the traditional treatment group （3.24±0.00） cGy.s^-1.cm^-2（F =1.742,P =0.000）.Two years after treatment,the score in the dynamic treatment group was （2.94 ± 1.22） points,which was lower than that in the traditional treatment group （4.21 ± 1.68） （F =93.841,P =0.000）;the complication rate and recurrence rate were 0.9% （3/323） and 0.6% （2/323） in dynamic treatment group while 11.1% （28/252） and 9.5% （24/252）in traditional treatment group,respectively.The difference was statistically significant （χ^2 =457.69,P =0.000;χ^2 =457.70,P =0.000）.Conclusions The treatment of surgery combined with 90Sr isotope is effective in pathological scar,but treatment programs should be developed as a dynamic treatment according to the individual characteristics of the pathological scar.