手术切除后超减张缝合联合浅层放射治疗瘢痕疙瘩的疗效观察

Clinical observation of surgical excision,supertractive suture combined with superficial radiotherapy in the treatment for keloid

目的探讨手术切除后超减张缝合联合浅层放射治疗瘢痕疙瘩的疗效和安全性。方法回顾性分析自2020年6月至2022年1月,青岛市第八人民医院美容医学科对15例瘢痕疙瘩患者(19块瘢痕疙瘩)采取手术切除后超减张缝合切口,术后24 h内接受浅层放射治疗的综合方法治疗,采用6 Me V电子线照射,一个疗程照射5次,总剂量15 Gy。联合治疗前、后采用改良温哥华瘢痕量表(modified vancouver scar scale,m VSS)、患者和观察者瘢痕评估量表(patient and observer scar assessmentscale,POSAS)对治疗效果进行评价;治疗后随访12个月,观察疗效、不良反应并统计复发率。结果患者联合治疗后1、6个月的m VSS评分及POSAS评分较治疗前均有所降低,总有效率为93.3%,仅有1例复发,复发率为6.7%。放射治疗后1~3个月局部色素沉着发生率为33.3%(5/15),均在6~9个月后自行消退,未发生伤口延迟愈合、皮炎等并发症。结论采用手术切除后超减张缝合联合浅层放射治疗瘢痕疙瘩是一种疗程较短、复发率较低,安全性较好的治疗方法。

Objective To investigate the efficacy and safety of surgical excision,supertensioning suture combined with superficial radiotherapy in the treatment of keloid.Methods Retrospective analysis from June 2020 to January 2022,Department of Cosmetic Medicine,Qingdao Eighth People's Hospital,15 patients with keloid(19 pieces of keloids)were treated with weed with surgical excision,hypertension-suture incision,and received superficial radiotherapy within 24 hours after surgery.The patients were treated with 6 Me V electron irradiation,5 times in a course of treatment,with a total dose of 15 Gy.Modified Vancouver Scar Scale(m VSS)and Patient and Observer Scar Assessment Scale(POSAS)were used before and after combination therapy.Follow-up was conducted for 12 months after treatment to observe the efficacy,adverse reactions and recurrence rate.Results The m VSS score and POSAS score of patients at 1 and6 months after combined treatment decreased compared to before treatment,the total effective rate was 93.3%,there was only one recurrence,and the recurrence rate was 6.7%.The incidence of local pigmentation was 33.3%(5/15)from 1 to 3 months after radiotherapy,which all subsided after 6 to 9 months,and no complications such as delayed wound healing and dermatitis occurred.Conclusion Surgical excision,supertractive suture combined with superficial radiotherapy is a better treatment for keloid.