整形手术与放射性敷贴联合治疗瘢痕疙瘩的临床效果观察(1)
【摘要】 目的：探讨整形手术联合放射性敷贴治疗瘢痕疙瘩的临床治疗效果。方法：选取本院2014年1月-2016年12月期间整形烧伤科、皮肤性病科收治的瘢痕疙瘩69例患者，根据患者就诊号分为两组，35例单号就诊号为观察组，34例双号就诊号为对照组。对照组予以单纯整形手术切除瘢痕疙瘩治疗，观察组切除瘢痕疙瘩的整形手术后1 d联合放射性敷贴治疗，观察两组治疗效果、治疗后美观满意度及治疗前后VAS评分。结果：观察组治愈率及总有效率分别为54.28%、91.43%，显著高于对照组的29.41%、73.53%(P<0.05)。两组治疗前VAS评分比较，差异无统计学意义(P>0.05)；治疗后两组VAS评分均较治疗前有显著的提高(P<0.05)；治疗后观察组VAS评分明显高于对照组(P<0.05)。观察组美观非常满意度及总满意度分别为60.00%、94.29%，显著高于对照组的32.35%、70.59%(P<0.05)。结论：整形手术联合放射性敷贴治疗瘢痕疙瘩效果较单纯手术治疗效果更为显著，且可满足患者对美观的要求。
【关键词】 整形手术； 放射性敷贴； 瘢痕疙瘩； 效果
Clinical Observation on the Treatment of Keloid by Plastic Surgery Combined with Radioactive/JIANG Le-wen，GUAN Kui，ZHAO Ming-quan.//Medical Innovation of China，2017，14(17)：118-121
【Abstract】 Objective：To explore the clinical effect of plastic surgery combined with radioactive application on keloid.Method：A total of 69 patients with keloid were treated with plastic surgery from January 2014 to December 2016.According to hospital number，they was divided into the observation group(35 cases of odd number) and the control group (34 cases of even number).The control group was treated with plastic surgery，the observation group was treated with radiotherapy after 1 day of plastic surgery.The therapeutic effect，the aesthetic satisfaction after treatment and VAS score before and after treatment of two groups were observed.Result：The cure rate and total effective rate of the observation group were 54.28%，91.43%，significantly higher than 29.41%，73.53% of the control group(P<0.05).VAS score of two groups before treatment was similar(P>0.05).After treatment，VAS score of two groups were higher than before(P<0.05)，and VAS score of the observation group was significantly higher than that of the control group(P<0.05).Very satisfaction rate and total satisfaction rate of the observation group were 60.00%，94.29%，significantly higher than 32.35%，70.59% of the control group(P<0.05).Conclusion：Plastic surgery combined with radioactive application in keloid treatment is more effective than the simple surgical treatment，and can meet the requirements of beauty for patients.
【Key words】 Plastic surgery； Radioactive application； Keloid； Effect
First-author’s address：Shenzhen Longgang Central Hospital，Shenzhen 518116，China
doi：10.3969/j.issn.1674-4985.2017.17.030
烧烫伤、外伤、创伤、痤疮(青春痘)、打耳孔、打预防针等人体皮肤局部创伤后修复过程中，纤维细胞异常增殖并分泌大量细胞外基质形成的瘢痕并继续增大和生长称为瘢痕疙瘩[1]，是皮肤纤维化疾病的一种。瘢痕疙瘩在一定程度上具有肿瘤特性但不具有肿瘤转移性和异型性，有学者将瘢痕疙瘩视为一种良性皮肤肿瘤[2]，主要有“蟹足样”浸润性生长和超过原伤口界限，患者常自觉有疼痛和各种瘙痒等症状的出现[3]，病程较长且难以自愈，严重者甚至造成外形及功能障碍，对患者的生活质量产生影响[4]，临床上对瘢痕疙瘩的治疗主要采用手术、局部注射糖皮质激素、激光、压迫、放射、冷冻、硅胶薄膜敷贴等多种治疗方法，但任何单一治疗方法的效果均欠佳且复发率较高[5]。为探讨有效的瘢痕疙瘩治療方法，本次笔者对2014年, 百拇医药(江乐文 关魁 赵明权)
【关键词】 整形手术； 放射性敷贴； 瘢痕疙瘩； 效果
Clinical Observation on the Treatment of Keloid by Plastic Surgery Combined with Radioactive/JIANG Le-wen，GUAN Kui，ZHAO Ming-quan.//Medical Innovation of China，2017，14(17)：118-121
【Abstract】 Objective：To explore the clinical effect of plastic surgery combined with radioactive application on keloid.Method：A total of 69 patients with keloid were treated with plastic surgery from January 2014 to December 2016.According to hospital number，they was divided into the observation group(35 cases of odd number) and the control group (34 cases of even number).The control group was treated with plastic surgery，the observation group was treated with radiotherapy after 1 day of plastic surgery.The therapeutic effect，the aesthetic satisfaction after treatment and VAS score before and after treatment of two groups were observed.Result：The cure rate and total effective rate of the observation group were 54.28%，91.43%，significantly higher than 29.41%，73.53% of the control group(P<0.05).VAS score of two groups before treatment was similar(P>0.05).After treatment，VAS score of two groups were higher than before(P<0.05)，and VAS score of the observation group was significantly higher than that of the control group(P<0.05).Very satisfaction rate and total satisfaction rate of the observation group were 60.00%，94.29%，significantly higher than 32.35%，70.59% of the control group(P<0.05).Conclusion：Plastic surgery combined with radioactive application in keloid treatment is more effective than the simple surgical treatment，and can meet the requirements of beauty for patients.
【Key words】 Plastic surgery； Radioactive application； Keloid； Effect
First-author’s address：Shenzhen Longgang Central Hospital，Shenzhen 518116，China
doi：10.3969/j.issn.1674-4985.2017.17.030
烧烫伤、外伤、创伤、痤疮(青春痘)、打耳孔、打预防针等人体皮肤局部创伤后修复过程中，纤维细胞异常增殖并分泌大量细胞外基质形成的瘢痕并继续增大和生长称为瘢痕疙瘩[1]，是皮肤纤维化疾病的一种。瘢痕疙瘩在一定程度上具有肿瘤特性但不具有肿瘤转移性和异型性，有学者将瘢痕疙瘩视为一种良性皮肤肿瘤[2]，主要有“蟹足样”浸润性生长和超过原伤口界限，患者常自觉有疼痛和各种瘙痒等症状的出现[3]，病程较长且难以自愈，严重者甚至造成外形及功能障碍，对患者的生活质量产生影响[4]，临床上对瘢痕疙瘩的治疗主要采用手术、局部注射糖皮质激素、激光、压迫、放射、冷冻、硅胶薄膜敷贴等多种治疗方法，但任何单一治疗方法的效果均欠佳且复发率较高[5]。为探讨有效的瘢痕疙瘩治療方法，本次笔者对2014年, 百拇医药(江乐文 关魁 赵明权)