皮肤内外同时减张联合术后早期放疗治疗胸部瘢痕疙瘩临床效果研究

Clinical Effects Study on Treatment of Thoracic Keloid by Simultaneous Tension Reduction Inside and Outside the Skin Combined with Early Postoperative Radiotherapy

目的:探索皮肤内外同时减张联合术后早期放疗治疗胸部瘢痕疙瘩的临床效果。方法:选取笔者科室2018年9月-2020年9月收治的20例胸部瘢痕疙瘩患者为研究对象,均符合胸部瘢痕疙瘩诊断标准,按随机数表法分为对照组与观察组各10例。对照组倒刺线超减张缝合术后早期放疗治疗;观察组皮肤内倒刺线超减张缝合术后早期放疗治疗加外用皮肤减张缝合器。比较两组治疗前后的瘢痕程度[采用新温哥华瘢痕量表(Vancouver scar scale,VSS)评估]。结果:治疗6个月后,观察组VSS各指标评分均低于对照组,差异有统计学意义(P<0.05)。结论:皮肤内外同时减张联合术后早期放疗治疗胸部瘢痕疙瘩可进一步持久减小手术切口的张力,抑制切口瘢痕的增生,减少复发率,外观美观,患者满意率较高,操作简单易行,值得临床推广应用。

Objective To explore the clinical eff ect of simultaneous tension reduction inside and outside the skin combined with early postoperativ radiotherapy for the treatment of thoracic keloid.Methods The research subjects selected 20 chest keloid patients from September 2018 to September 2020,and all of them met the diagnostic criteria for chest keloid.It was divided into control and observation groups according to random number table,with 10 cases in each group.The control group received early radiotherapy after skin tension-reduction suture method.The observation group was treated with early radiotherapy after intracutaneous barbed tension-reduction suture method and external medical skin tension-reduction suture device.The degree of scarring was compared before and after treatment between the two groups[as assessed using the New Vancouver Scarring Scale(Vancouver scar scale,VSS)].Results After 6 months of treatment,the score of VSS in the observation group was lower than that in the control group,which was signifi cant(P<0.05).Conclusion Simultaneous tension reduction inside and outside the skin combined with early postoperative radiotherapy for chest keloids can further persistently reduce the tension of the surgical incision,inhibit the hyperplasia of the incision scar,reduce the recurrence rate,beautiful appearance,high patient satisfaction rate,simple and easy operation,which is worth clinical promotion and application.