中国医疗美容
中國醫療美容
중국의료미용
China Medical Cosmetology
2014年
4期
5-7
,共3页
张帆%张扬%高竞逾%龙瑞清
張帆%張颺%高競逾%龍瑞清
장범%장양%고경유%룡서청
瘢痕疙瘩%耳廓%耳垂%手术%放射%治疗效果
瘢痕疙瘩%耳廓%耳垂%手術%放射%治療效果
반흔흘탑%이곽%이수%수술%방사%치료효과
Keloid%Ear Auricle%Earlobe%Surgery%Radiotherapy%Treatment outcome
目的：探讨耳部瘢痕疙瘩手术切除及术后综合治疗的方法和效果。方法：选取126例患者共计152耳。根据瘢痕疙瘩的位置、大小选择不同的手术方法进行病变切除和耳部整形。术后24h内对手术区域进行电子线照射，每次3Gy，每日一次，照射7天。对有复发倾向的患者，用曲安奈德1ml（40mg）与2%利多卡因3ml混合后在病变部位注射，每3～4周1次。观察记录治疗后1年随访结果。结果：所有患者切口均Ⅰ期愈合，移植皮瓣均成活。93例（109耳）患者随访时间＞1年，达到临床治愈。33例（43耳）患者在放疗结束后3～6个月出现复发倾向，给予曲安奈德病变部位注射后，随访1年后未出现复发。根据Darzi的瘢痕疙瘩疗效判定标准，治愈93例，显效33例。结论：耳部瘢痕疙瘩需进行个体化手术切除及耳部整形，术后尽早进行放射治疗及其他方法的综合治疗，可以取得满意效果。
目的：探討耳部瘢痕疙瘩手術切除及術後綜閤治療的方法和效果。方法：選取126例患者共計152耳。根據瘢痕疙瘩的位置、大小選擇不同的手術方法進行病變切除和耳部整形。術後24h內對手術區域進行電子線照射，每次3Gy，每日一次，照射7天。對有複髮傾嚮的患者，用麯安奈德1ml（40mg）與2%利多卡因3ml混閤後在病變部位註射，每3～4週1次。觀察記錄治療後1年隨訪結果。結果：所有患者切口均Ⅰ期愈閤，移植皮瓣均成活。93例（109耳）患者隨訪時間＞1年，達到臨床治愈。33例（43耳）患者在放療結束後3～6箇月齣現複髮傾嚮，給予麯安奈德病變部位註射後，隨訪1年後未齣現複髮。根據Darzi的瘢痕疙瘩療效判定標準，治愈93例，顯效33例。結論：耳部瘢痕疙瘩需進行箇體化手術切除及耳部整形，術後儘早進行放射治療及其他方法的綜閤治療，可以取得滿意效果。
목적：탐토이부반흔흘탑수술절제급술후종합치료적방법화효과。방법：선취126례환자공계152이。근거반흔흘탑적위치、대소선택불동적수술방법진행병변절제화이부정형。술후24h내대수술구역진행전자선조사，매차3Gy，매일일차，조사7천。대유복발경향적환자，용곡안내덕1ml（40mg）여2%리다잡인3ml혼합후재병변부위주사，매3～4주1차。관찰기록치료후1년수방결과。결과：소유환자절구균Ⅰ기유합，이식피판균성활。93례（109이）환자수방시간＞1년，체도림상치유。33례（43이）환자재방료결속후3～6개월출현복발경향，급여곡안내덕병변부위주사후，수방1년후미출현복발。근거Darzi적반흔흘탑료효판정표준，치유93례，현효33례。결론：이부반흔흘탑수진행개체화수술절제급이부정형，술후진조진행방사치료급기타방법적종합치료，가이취득만의효과。
Objective:To investigate the effectiveness of surgical excision combined with adjuvant therapy on the aural region keloid. Methods:126 patients(152 side ears)with keloid at the aural region were treated. According to the different sizes and the range of keloids,different operations to remove the keloids and repair the defect tissue were chosen. Wounds were exposed to the electron beam at first 24 hours after operation,once a day at 3 Gy each time for 7 days. An immediate local injection for the keloid with hormones anti-scar drugs,which was a mixture of Triamcinolone and 2% Lidocaine with a proportion of 1:3,was given to the patients who had recurrence trend 1 time every 3-4 weeks. Results:After operation,all the wounds had healed by first intention. 93 cases(109 side ears)were followed up for more than 1 year,and all achieved clinical cure. 33 cases(43 lateral ears)had the trend of recurrence 3~6 months after operation and were cured after the immediate local injection for the keloid with hormones anti-scar drugs. According to Darzi’s curative criterion,93 cases were cured and 33 cases responded to treatment. Conclusion:Surgical excision and plastic combined with local radiation and hormones infiltrated individually as early as possible can effectively treat aural region keloids. And it is an optimal method.
