手术切除、激素注射、放疗的多种组合方式在瘢痕疙瘩中的疗效差异研究

Study on the differences in efficacy of various combinations of surgical resection,hormone injection,radiotherapy and chemotherapy in keloid scars

目的评估手术切除、激素注射、放疗不同组合治疗方式在瘢痕疙瘩患者中的疗效差异。方法选取2021年10月至2023年10月于我院就诊的瘢痕疙瘩患者120例,根据治疗方法分为手术+激素注射组、手术+放疗组、激素注射+放疗组、手术+激素注射+放疗组,每组30例。评价各组患者的总有效率、不良反应发生率、复发率和生存质量变化。结果①手术+激素注射+放疗组总有效率最高、其次是手术+激素注射组、再次是手术+放疗组,激素注射+放疗组总有效率最低。手术+激素注射+放疗组、手术+激素注射组、手术+放疗组三组组间无明显差异(P>0.05),但三组总有效率均与激素注射+放疗组差异显著(P<0.05)。②不良反应发生率最低为手术+激素注射组(3.33%),最高为激素注射+放疗组(33.33%),差异有统计学意义(P<0.05);③复发率最低为手术+激素注射+放疗组(3.33%),最高为激素注射+放疗组(30%),差异有统计学意义(P<0.05);④生存质量评分最佳为手术+激素注射+放疗组,最差为激素注射+放疗组(P<0.05)。结论手术+激素注射+放疗组合方式总体疗效最优,不良反应与复发率最低,对患者生存质量影响最小。手术联合激素注射的组合方案与手术联合放疗组合方案治疗效果相当,激素联合放疗组合治疗效果相对较差。

Objective To assess the effectiveness of various therapeutic strategies,including surgical excision,hormonal therapy,radiation treatment,and chemical therapy,in individuals afflflicted with keloid lesions.Methods 120 patients with scar tissue who visited our hospital from October 2021 to October 2023 were selected and divided into surgery+hormone injection group,surgery+radiation group,hormone injection+radiation group,surgery+hormone injection+radiation group,and surgery+hormone injection+radiation group according to the treatment method,with 30 cases in each group.The total effective rate,incidence of adverse reactions,recurrence rate,and changes in quality of life of each group of patients were evaluated.Results The group receiving a combination of surgical removal,hormonal injections,and radiation therapy exhibited the highest rate of effectiveness,succeeded by the group treated with surgery and hormone therapy,and then the group treated with surgery and radiation therapy.The group treated with hormone injections and radiation therapy had the lowest rate of effectiveness.The differences in effectiveness between the combined treatment group,the surgery and hormone therapy group,and the surgery and radiation therapy group were not statistically signifificant(P>0.05),yet these three groups showed a signifificant difference when compared to the hormone injection and radiation therapy group(P<0.05).The incidence of adverse reactions was least in the group treated with surgery and hormone injections(3.33%),and most prevalent in the group treated with hormone injections and radiation therapy(33.33%),with the disparity being statistically signifificant(P<0.05).The recurrence rate was lowest in the group treated with surgery,hormone injections,and radiation therapy(3.33%),while the highest recurrence was observed in the group treated with hormone injections and radiation therapy(30%),marking a statistically signifificant difference(P<0.05).The highest quality of life scores were recorded in the group treated with surgery,hormone injections,and radiation therapy,whereas the lowest scores were noted in the group treated with hormone injections and radiation therapy(P<0.05).Conclusion The therapeutic regimen combining surgical intervention,hormonal therapy,and radiation treatment yields the most favorable outcomes,with the minimal incidence of side effects and recurrences,and the smallest inflfluence on patients'life quality.The effificacy of the dual approach of surgery plus hormone therapy is comparable to that of surgery plus radiation therapy,whereas the effificacy of hormone therapy in conjunction with radiation therapy is comparatively suboptimal.