手术切除联合丝裂霉素C治疗耳廓增生性瘢痕的临床疗效

Clinical effect of mitomycin C combined with operation in the treatment of hyperplastic scar of auricle

目的:观察手术切除联合丝裂霉素C治疗不同直径耳廓增生性瘢痕的临床疗效及术后复发率。方法:收集2011年1月至2019年6月在萍乡市第二人民医院和萍矿总医院就诊的53名患者(67耳),随机分为联合治疗组(31耳)及对照组(36耳)。联合治疗组采用手术切除包块后,立即在创面上覆盖含0.4 mg/mL丝裂霉素C的棉片浸润5 min,再缝合切口;对照组行单纯手术切除。随访1至3年,观察2组不同直径增生性瘢痕的术后复发率。结果:联合治疗组5耳复发,复发率16.1%;对照组19耳复发,复发率52.8%。不同直径包块术后切除效果:联合治疗组中直径(>1.0~3.0 cm)的增生性瘢痕术后复发率较对照组明显降低(χ2=10.804,P<0.05),而小微直径(≤1.0 cm)和大直径(>3.0 cm)的包块,术后复发率差异均无统计学意义(均P>0.05)。结论:丝裂霉素C联合手术治疗可明显降低中直径耳廓增生性瘢痕的复发率或延缓其复发,而对于过大或过小直径的增生性瘢痕疗效与单纯手术无异。

Objective: To observe the clinical effect and recurrence rate of mitomycin C combined with operation in the treatment of hyperplastic scar of auricle with different diameters.Methods: A total of 53 patients(67 ears) collected from January 2011 to June 2019 were randomly divided into a combined treatment group(31 ears) and a control group(36 ears).The recurrence rate was observed from one year to three years after operation.Results: The recurrence rate was 52.8% in the control group and 16.1% in the combined treatment group, respectively. For the hyperplastic scar of auricle with diameter from >1.0 cm to 3.0 cm, the recurrence rate was significantly lower in the combined treatment group than that in the control group(χ~2=10.804, P<0.05). But there was no significant difference for the hyperplastic scar of auricle with diameter less than 1.0 cm or more than 3.0 cm(both P>0.05).Conclusion: Mitomycin C combined with surgery can significantly reduce or delay the recurrence rate of middle diameter of hyperplastic scar of auricle, but it does not affect the hyperplastic scar of auricle with too large or too small diameter.