MEBO在瘢痕疙瘩^(90)Sr同位素放射治疗中的应用效果分析

Efficacy Analysis of MEBO in the Treatment of Post-operative Wound of Radiotherapy with Strontium-90 for Keloids

目的探讨湿润烧伤膏(MEBO)在瘢痕疙瘩锶-90(^(90)Sr)同位素放射治疗中的应用效果。方法选取2019年1月至2020年6月重庆医科大学附属第一医院收治的79例瘢痕疙瘩患者(共99处瘢痕疙瘩)作为研究对象,并按照随机数表法将其随机分为治疗组38例(46处瘢痕疙瘩)和对照组41例(53处瘢痕疙瘩),治疗组患者于瘢痕疙瘩切除术后及^(90)Sr同位素放射治疗后,切口及照射部位行MEBO换药治疗;对照组患者于术后及放射治疗后,切口及照射部位行常规碘伏换药治疗,对比两组患者切口愈合情况、治疗期间放射性皮肤损伤情况及疗程结束后瘢痕评分、瘙痒与色素沉着情况。结果治疗组患者切口愈合时间及疗程结束后瘢痕评分与对照组无明显差异(Z=-1.598、-1.475,P=0.110、0.140),而放射性皮肤损伤、瘙痒及色素沉着发生情况均轻于对照组(Z=-2.135、-2.435、-3.222,P=0.033、0.015、0.001)。结论MEBO可减轻瘢痕疙瘩切除术后^(90)Sr同位素放射治疗所致的放射性皮肤损伤、瘙痒及色素沉着程度,对提高瘢痕疙瘩的治疗效果具有积极作用。

Objective To explore the efficacy of MEBO in the treatment of post-operative wound of radiotherapy with Strontium-90(^(90)Sr)for keloids.Methods 79 patients with keloids(99 keloids in total),admitted to the First Affiliated Hospital of Chongqing Medical University from January 2019 to June 2020,were enrolled and divided into treatment group(38 patients with 46 keloids)and control group(41 patients with 53 keloids)using random number table.After keloid excision and Sr^(90) radiotherapy,patients in treatment group were treated with dressing change of MEBO on the incision and irradiated sites,whereas the control group were treated with conventional dressing change of povidone iodine solution.Healing status of incision,radiation-induced skin injury during the course of treatment,and the VSS score,itching and hyperpigmentation after the course of treatment,were compared between the two groups.Results There was no significant difference between the two groups in terms of incision healing time and VSS score after treatment(Z=-1.598 and-1.475,P=0.110 and 0.140).However,the occurrences of radiation-induced skin injury,itching and hyperpigmentation in treatment group were less than control group(Z=-2.135,-2.435,-3.222,P=0.033,0.015,0.001).Conclusion MEBO improved the treatment of keloids by relieving the occurrences of radiation-induced skin injury,itching and hyperpigmentation after Sr^(90) radiotherapy following the keloid resection.