瘢痕疙瘩放射治疗的疗效与皮肤张力的关系

doi:10.6040/j.issn.1671-7554.0.2014.819

山东大学学报（医学版） ›› 2015, Vol. 53 ›› Issue (7): 78-81.doi: 10.6040/j.issn.1671-7554.0.2014.819

瘢痕疙瘩放射治疗的疗效与皮肤张力的关系

李中华¹, 王海琴², 孙玉凯¹, 芦昌慧¹, 杨波¹, 王一民¹

1. 济南市第四人民医院烧伤整形科, 山东济南 250031;
2. 济南市第五人民医院妇产科, 山东济南 250021

收稿日期:2014-11-12 修回日期:2015-03-05 发布日期:2015-07-10
通讯作者: 孙玉凯。E-mail:jinansky@163.com E-mail:jinansky@163.com
基金资助:
济南市卫生局科技计划(2008-20)

Dose-effect relationship for keloids between skin tension and radiotherapy

LI Zhonghua¹, WANG Haiqin², SUN Yukai¹, LU Changhui¹, YANG Bo¹, WANG Yimin¹

1. Department of Burns and Plastic Surgery, Jinan Fourth People's Hospital, Jinan 250031, Shandong, China;
2. Department of Obstetrics and Gynecology, Jinan Fifth People's Hospital, Jinan 250021, Shandong, China

Received:2014-11-12 Revised:2015-03-05 Published:2015-07-10

摘要/Abstract

摘要： 目的比较低张力、高张力部位瘢痕疙瘩、放射剂量与临床疗效的关系, 探讨放射治疗的最优方式。方法选取48例瘢痕疙瘩患者, 其中25例有2处瘢痕位于高张力区:胸部、肩部、耻骨部;23例有2处瘢痕位于低张力区:耳部、颌颈部, 采用随机、开放、自身对照的前瞻性研究方法, 分为高剂量组(A组)、低剂量组(B组)。患者均首先采用二氧化碳点阵激光治疗, 创面愈合24 h内, 给予采用³²P敷贴器治疗,A组和B组分别给予7 Gy、5 Gy, 共3次, 放射总剂量分别为21 Gy、15 Gy。比较2组患者的临床疗效和不良反应的发生率。结果 ①低张力区:A组患者治愈率(95.2%)和温哥华瘢痕量表评分(5.21±0.78), 与B组患者治愈率(80.9%)和温哥华瘢痕量表评分(5.43±0.53)比较差异无统计学意义(χ²=2.043, t=1.069, P>0.05)。A组不良反应发生率(71.4%)高于B组(38.1%), χ²=4.709, P<0.05;②高张力区:A组患者治愈率(75.0%)和温哥华瘢痕量表评分(5.56±0.51)优于B组患者治愈率(41.7%)和温哥华瘢痕量表评分(6.96±0.71), χ²=5.486, t=7.846, P<0.05。结论瘢痕疙瘩应根据不同位置采取不同放射剂量。对于低张力区瘢痕疙瘩分3次给予15 Gy, 高张力区瘢痕疙瘩分3次给予21 Gy, 能取得较好的临床疗效。

关键词: 瘢痕疙瘩, 点阵激光, 张力, 放射剂量, ³²P敷贴

Abstract: Objective To evaluate the association of radiation dose for high-tension and low-tension keloids and to explore the optimal radiotherapy. Methods Of the 48 patients, 25 had two keloids in high-tension parts such as anterior chest wall, scapulae and pubis, and 23 had two keloids in low-tension parts such as ear and neck. The patients were divided into two groups: high radiation dose group (group A) and low radiation dose group (group B). All patients received fractional CO₂ laser to remove the hypertrophic scar. After wound healing, patients in group A were treated with 7 Gy 3 times by ³²P applicator; patients in group B were treated with 5 Gy 3 times. The clinical efficacy and side effects were compared between the two groups. Results For low-tension parts: there were no significant differences between the two groups in cure rates and VSS scores (95.2% vs 80.9%, 5.21±0.78 vs 5.43±0.53, χ²=2.043, t=1.069, P>0.05). The ratio of side effects in group A was significantly higher than that in group B (71.4% vs 38.1%, χ²=4.709, P<0.05). For high-tension parts: the cure rate and VSS in group A were markedly higher than those in group B (75.0% vs 41.7%, 5.56±0.51 vs 6.96±0.71, χ²=5.486, t=7.846, P<0.05). Conclusion For better curative effects, keloids in low-tension parts should be treated with 15 Gy in 3 fractions, while keloids in high-tension parts should be treated with 21 Gy in 3 fractions.

Key words: Radiation dose, Keloid, Fractional laser, ³²P applicator, Tension

中图分类号:

R622+.9

李中华, 王海琴, 孙玉凯, 芦昌慧, 杨波, 王一民. 瘢痕疙瘩放射治疗的疗效与皮肤张力的关系[J]. 山东大学学报（医学版）, 2015, 53(7): 78-81.

LI Zhonghua, WANG Haiqin, SUN Yukai, LU Changhui, YANG Bo, WANG Yimin. Dose-effect relationship for keloids between skin tension and radiotherapy[J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2015, 53(7): 78-81.

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瘢痕疙瘩放射治疗的疗效与皮肤张力的关系

Dose-effect relationship for keloids between skin tension and radiotherapy

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