手术联合多种方法治疗耳部瘢痕的疗效对比研究

发布时间：2019-08-14 13:13

【摘要】：目的:评价耳部瘢痕手术切除联合术中糖皮质激素局部注射及术后浅层电子线照射治疗的临床效果,以期找到一套以外科手术为主的个性化综合治疗体系。方法:将160例耳部瘢痕患者分为单纯手术组、手术联合得宝松局部注射组、手术联合浅层电子线照射组及手术联合术中激素和术后浅层电子线照射组(三联疗法组),并随访1年。依据Darzi的瘢痕疙瘩疗效标准判断疗效,并进行统计学分析。结果:术后1年单纯手术组有效率为52.5%,手术联合得宝松局部注射组有效率为80.0%,手术联合浅层电子线照射组有效率为82.5%,三联疗法组有效率为97.5%。单纯手术组的疗效明显低于其他3组(P0.01);三联疗法组的疗效优于手术联合浅层电子线照射组以及手术联合得宝松注射组,差异有统计学意义(P0.05);而手术联合得宝松注射组与手术联合浅层电子线照射组相比,疗效差异无统计学意义(P0.05)。结论:在耳部瘢痕治疗中,单纯手术切除疗效差,不推荐;三联疗法优于手术联合糖皮质激素局部注射和手术联合浅层电子线照射,应作为治疗首选;手术联合糖皮质激素局部注射和手术联合浅层电子线照射疗效总体满意,可以根据具体情况个性化使用。
[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.
【作者单位】： 山西省人民医院耳鼻咽喉科;山西省儿童医院手术部;
【分类号】：R764.9
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本文编号：2526590