手术切除与术后压力治疗耳部瘢痕疙瘩的临床疗效观察(1)
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[摘要]目的:评价采取手术个体化切除与术后压力综合治疗耳部瘢痕疙瘩的临床效果。方法:2006年1月～2007年12月收治92例(117侧)耳部瘢痕疙瘩患者。男8例,女84例;年龄16～43岁,平均26.2岁,病程1～24年。瘢痕疙瘩范围0.3cm× 0.3cm×0.3cm～6.0cm×4.5cm×2.2cm,形状各异。根据瘢痕疙瘩不同大小和范围,选择不同术式切除瘢痕疙瘩并行缺损修复。术后7天拆线后开始采用耳夹局部压力治疗,保持加压状态持续1年时间。结果:术后患者切口Ⅰ期愈合87例(112侧),5例出现皮瓣下血肿,换药后伤口愈合,皮瓣均成活。92例(117侧)获随访1年,单纯手术组患者23例(27侧),治愈2例(2侧),显效6例(9侧),复发15例(16侧);手术加术后压力治疗组患者69例(90侧),治愈42例(56侧),显效21例(25侧),复发6例(9侧)。两组结果进行Ridit分析:R=0.1513±0.0695,P<0.05,有显著性差异。结论:耳部瘢痕疙瘩可以采用个体化手术方式切除,结合术后加压治疗,可取得满意效果,是治疗的选择方案之一。
[关键词]耳;瘢痕疙瘩;手术;压力治疗
[中图分类号]R622 [文献标识码]A [文章编号]1008-6455(2010)07-0947-03
Clinical study of excision and postoperative pressure therapy for keloid in aural region
CAI Zhen1,YOU Xiao-bo1,ZHANG Jia-jian1,FU Rong1,LIU Quan1,ZHANG Li-xia2
(1. Plastic Surgery Department, 2. Department of Dermatology, Sichuan Academy of Medical Sciences and Sichuan Provincial People's Hospital,Chengdu610072,Sichuan,China)
Abstract:ObjectiveTo investigate the effect of individualized excision and postoperative pressure therapy for keloid in aural region.MethodsJanuary 2006 to December 2007, 92 patients (117 side ears) with keloid at the aural region were treated. There were 8 males and 84 females, aged 16 to 43 years (mean 24.8 years). The course of disease ranged from 1 to 24 years. The sizes of keloids ranged from 0.3cm × 0.3cm× 0.3 cm to 6.0cm × 4.5cm × 2.2 cm with different shapes. According to the different sizes and the range of keloids, different operations to remove the keloids and repair the defect tissue were chosen. Pressure therapy were began at 7 days after operation, and continued more than one year.ResultsAfter operation, 87 patients (112 lateral ears) healed by first intention. Hematoma under flap was appear in 5 patients, and healed by changing dressings. And 92 cases(117 lateral ears) were followed up for 1 year. Simple operation groups: 23 patients (27 lateral ears), cure 2 patients (2 lateral ears), effective 6 patients (9 lateral ears), invalid 15 patients (16 lateral ears); operation and pressure therapy groups: 69 patients (90 lateral ears), cure 42 patients (56 lateral ears), effective 21 patients (25 lateral ears), invalid 6 patients (9 lateral ears) ......
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