深部埋置环形褥式缝合联合浅层X射线放射治疗胸背部瘢痕疙瘩的疗效分析

Curative effect of deep buried annular mattress suture combined with shallow X-ray radiation therapy in the treatment of keloid on chest and back

目的探讨深部埋置环形褥式缝合联合浅层X射线放射治疗胸背部瘢痕疙瘩的临床疗效。方法选取102例胸背部瘢痕疙瘩患者,采用深部埋置环形褥式缝合技术进行治疗,术后进行病理HE染色分析,于术后24 h内行第1次浅层X射线放射治疗,每隔5 d 1次,共4次。于术后1个月、3个月、6个月及1年观察患者的临床疗效,记录患者术后并发症发生率及满意率。结果瘢痕组织HE染色可见表皮萎缩变薄,真皮中上部成纤维细胞及胶原增生,增生的毛细血管周围可见稀疏的炎细胞浸润。术后1个月、3个月、6个月及1年,患者治疗有效率分别为100%、99.02%、96.08%及89.22%;术后总体并发症发生率为16.67%,总体满意率为97.06%。结论胸背部瘢痕疙瘩手术切除后采取深部埋置环形褥式缝合技术联合浅层X射线放射治疗,患者可取得较好的临床疗效,且具有复发率低、无严重并发症等优点。

Objective To investigate the clinical effect of deep buried annular mattress suture combined with shallow X-ray radiation therapy in the treatment of keloid on chest and back.Methods A total of 102 patients with keloid on chest and back were selected and treated with deep buried annular mattress suture technique,and pathological HE staining analysis was performed after operation.The first shallow X-ray radiation therapy was performed within 24 hours after surgery,once every 5 days,4 times in total.The clinical efficacy of the patients was observed 1 month,3 months,6 months and 1 year after operation,and the incidence of postoperative complications and satisfaction rate of the patients were recorded.Results HE staining of scar tissue showed atrophy and thinning of epidermis,proliferation of fibroblasts and collagen in the middle and upper dermis,and sparse inflammatory cell infiltration around the proliferated capillaries.At 1 month,3 months,6 months and 1 year after operation,the effective rates of treatment were 100%,99.02%,96.08%and 89.22%respectively.The overall incidence of postoperative complications was 16.67%and the overall satisfaction rate was 97.06%.Conclusion After the surgical resection of keloid on chest and back,deep buried annular mattress suture combined with shallow X-ray radiation therapy can obtain better clinical effect,and have the advantages of low recurrence rate and no serious complications.