摘要
目的对比不同方法联合放射治疗(RT)修复薄型瘢痕疙瘩的临床疗效和安全性。方法回顾性分析2019年10月至2022年10月内蒙古医科大学附属肿瘤医院整形外科接诊的38例胸部瘢痕疙瘩患者(64个瘢痕疙瘩)及解放军联勤保障部队第九六九医院烧伤整形科接诊的16例胸部瘢痕疙瘩患者(35个瘢痕疙瘩),根据治疗方法不同分为RT组(n=18)、手术联合放射治疗(SCR)组(n=19)、CO_(2)点阵激光联合放射治疗(LCR)组(n=17),3组患者的瘢痕疙瘩数量分别为34、33、32个。分别于治疗前、治疗后6、12个月,采用温哥华瘢痕量表(VSS)及患者和观测者双向瘢痕评估量表(POSAS)评估瘢痕改善程度和临床疗效,采用李克特量表评价满意度,线上问卷评价不良反应和复发率,并记录治疗相关指标。结果RT组、SCR组及LCR组患者治疗后6、12个月时的POSAS总分和VSS评分均低于治疗前(P<0.01)。RT组治疗后12个月时的POSAS总分和VSS评分相较于治疗后6个月有所升高,SCR组和LCR组治疗后12个月时的POSAS总分和VSS评分相较于治疗后6个月均下降。其中治疗后12个月时,LCR组POSAS总分和VSS评分最低,SCR组次之,RT组最高。SCR组和LCR组有效率与RT组比较差异有统计学意义(χ^(2)=19.304,P<0.01),SCR组与LCR组比较,差异无统计学意义;RT组有效率为27.78%,SCR组有效率为78.95%,LCR组有效率为94.12%。SCR组和LCR组满意度与RT组比较差异有统计学意义(χ^(2)=10.41,P<0.01),SCR组与LCR组比较,差异无统计学意义;RT组满意度为52.94%,SCR组为84.21%,LCR组为94.12%。RT组治疗12个月后复发率为72.22%,SCR组复发率为21.05%,LCR组复发率为5.88%,1年复发率比较差异有统计学意义(χ^(2)=19.30,P<0.01)。结论LCR有操作简便高效、便于护理、创伤小、疗效好、安全性高的特点,患者容易接受,尤其适用于多发性或较大面积的薄型瘢痕疙瘩、有明显手术禁忌证或不愿接受手术治疗的患者。单纯的RT主�
Objective To explore and compare the clinical efficacy and safety of different methods combined with radiation therapy(RT)for repairing thin scar tissue.Methods A retrospective analysis was conducted on 38 patients with chest scars(64 scars)admitted to the Department of Plastic Surgery in Inner Mongolia Medical University Affiliated Cancer Hospital from October 2019 to October 2022,as well as 16 patients with chest scars(35 scars)admitted to the Department of Burn and Plastic Surgery in 969th Hospital of in the Joint Logistics Support Force of the People′s Liberation Army.According to different treatment methods,they were divided into radiotherapy(RT)group(n=18),surgery combined with radiotherapy(SCR)group(n=19),and CO_(2)dot array laser combined with radiotherapy(LCR).The combined with radiosurgery(LCR)group(n=17)had 34,33,and 32 scars in the three groups of patients,respectively.Before treatment,6 months and 12 months after treatment,the Vancouver scar scale(VSS)and patient and observer scar assessment scale(POSAS)were used to evaluate the degree of scar improvement and clinical efficacy.The Likert scale was used to evaluate satisfaction,and an online questionnaire was used to evaluate adverse reactions and recurrence rates.Treatment related indicators were recorded.Results The total POSAS score and VSS score of patients in the RT group,SCR group,and LCR group were lower than before treatment at 6 and 12 months after treatment(P<0.01).The total POSAS score and VSS score of the RT group increased compared to 6 months after treatment,while the total POSAS score and VSS score of the SCR and LCR groups decreased compared to 6 months after treatment.At 12 months after treatment,the LCR group had the lowest total POSAS score and VSS score,followed by the SCR group,and the RT group had the highest score.There was a significant difference in the effective rate between the SCR group and the LCR group compared to the RT group(χ^(2)=19.304,P<0.01),there was no significant difference between the SCR group and the LCR gr
作者
陈向军
于丽
王星
梁俊青
吴迪
李志军
Xiangjun Chen;Li Yu;Xing Wang;Junqing Liang;Di Wu;Zhijun Li(Department of Plastic Surgery,Inner Mongolia Medical University Graduate School,Inner Mongolia Medical University Affiliated Cancer Hospital,Peking University Cancer Hospital Inner Mongolia Hospital,Hohhot 010010,China;969th Hospital of the Joint Logistics Support Force of the People′s Liberation Army,Hohhot 010051,China;Department of Human Anatomy,School of Basic Medicine,Inner Mongolia Medical University,Hohhot 010110,China;Inner Mongolia Medical University Affiliated Cancer Hospital Peking University Cancer Hospital Inner Mongolia Hospital Breast Center,Hohhot 010010,China)
出处
《中华损伤与修复杂志（电子版）》
CAS
2024年第3期215-222,共8页
Chinese Journal of Injury Repair and Wound Healing(Electronic Edition)
