【摘要】：目的:評價耳部瘢痕手術切除聯(lián)合術中糖皮質激素局部注射及術后淺層電子線照射治療的臨床效果,以期找到一套以外科手術為主的個性化綜合治療體系。方法:將160例耳部瘢痕患者分為單純手術組、手術聯(lián)合得寶松局部注射組、手術聯(lián)合淺層電子線照射組及手術聯(lián)合術中激素和術后淺層電子線照射組(三聯(lián)療法組),并隨訪1年。依據Darzi的瘢痕疙瘩療效標準判斷療效,并進行統(tǒng)計學分析。結果:術后1年單純手術組有效率為52.5%,手術聯(lián)合得寶松局部注射組有效率為80.0%,手術聯(lián)合淺層電子線照射組有效率為82.5%,三聯(lián)療法組有效率為97.5%。單純手術組的療效明顯低于其他3組(P0.01);三聯(lián)療法組的療效優(yōu)于手術聯(lián)合淺層電子線照射組以及手術聯(lián)合得寶松注射組,差異有統(tǒng)計學意義(P0.05);而手術聯(lián)合得寶松注射組與手術聯(lián)合淺層電子線照射組相比,療效差異無統(tǒng)計學意義(P0.05)。結論:在耳部瘢痕治療中,單純手術切除療效差,不推薦;三聯(lián)療法優(yōu)于手術聯(lián)合糖皮質激素局部注射和手術聯(lián)合淺層電子線照射,應作為治療首選;手術聯(lián)合糖皮質激素局部注射和手術聯(lián)合淺層電子線照射療效總體滿意,可以根據具體情況個性化使用。
[Abstract]:Objective: to evaluate the clinical effect of surgical resection of ear scar combined with local injection of glucocorticoid and superficial electron ray irradiation after operation in order to find a personalized comprehensive treatment system based on surgery. Methods: 160 patients with ear scar were divided into simple operation group, local injection group, operation combined with superficial electron ray irradiation group and operation combined with intraoperative hormone and postoperative superficial electron ray irradiation group (triple therapy group). The patients were followed up for 1 year. According to the curative effect standard of Darzi keloid, the curative effect was judged and analyzed statistically. Results: one year after operation, the effective rate was 52.5% in the operation group, 80.0% in the local injection group, 82.5% in the operation combined with superficial electron ray irradiation group, and 97.5% in the triple therapy group. The curative effect of the simple operation group was significantly lower than that of the other three groups (P 0.01); the curative effect of the triple therapy group was better than that of the operation combined with shallow electron ray irradiation group and the operation combined with Debaosong injection group, the difference was statistically significant (P 0.05), but there was no significant difference between the operation combined with Baosong injection group and the operation combined with shallow electron ray irradiation group (P 0.05). Conclusion: surgical resection alone is not recommended in the treatment of ear scar, and triple therapy is superior to operation combined with local injection of glucocorticoid and operation combined with superficial electron ray irradiation, which should be the first choice for treatment. The curative effect of operation combined with local injection of glucocorticoid and operation combined with superficial electron line irradiation is generally satisfactory and can be used individualized according to the specific situation.
【作者單位】： 山西省人民醫(yī)院耳鼻咽喉科;山西省兒童醫(yī)院手術部;
【分類號】：R764.9
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本文編號：2526590