摘要
目的探讨能否通过低浓度5-氟尿嘧啶（5-Fu）和糖皮质激素联合使用的方法增加手术治疗耳郭瘢痕疙瘩的有效率并降低复发率。方法83例患者共166个耳郭瘢痕疙瘩，其中79个位于耳轮部，87个位于耳垂部，平均病史2．9年。77例（92．8％）因穿耳孔引起。首先手术切除瘢痕疙瘩，并尽量恢复耳郭正常形态。术后3～4周开始于术后瘢痕部局部注射低浓度5-Fu与糖皮质激素混合液，1次／4周。若瘢痕稳定无复发，逐渐过渡到2—3个月注射药物1次，并逐渐降低药物浓度。以耳郭外形恢复正常、停止药物注射后随访6个月以上无复发为痊愈，耳郭外形轻度畸形或术后时间超过6个月、瘢痕疙瘩未复发但尚不能停止药物注射治疗为有效，进行疗效评估。结果83例患者术后维持治疗期为2～26个月（平均7个月），停药随访期为0—49个月（平均9个月）。痊愈39例（47．0％），有效44例（53．0％），总有效率为100％。77例（92．7％）患者耳郭外形完全恢复正常。结论手术联合低浓度5．Fu和糖皮质激素局部注射是治疗耳郭瘢痕疙瘩的有效方法。
Objective To investigate whether intralesional injection of low-dose 5-fluorouracil （5- Fu） and corticosteroids can increase the effective rate and decrease the recurrence rate of surgically excised auricular keloid. Methods Eighty-three patients with 166 total ear keloids were studied, including 79 keloids of helix and 87 of earlobe with an average disease history of 2. 9 years. Ear piercing accounted for 92. 7% for etiology. Keloids were first surgically removed in order to keep the normal auricular shape. Then intralesional injection of a low-dose of 5-Fu and corticosteroids was given 3 -4 weeks after surgery and every 4 weeks afterwards. If no recurrence, the injection was given every 2 to 3 months with gradually tapered dose. The evaluation standard includes： patients with no recurrence 6 months after stopping drug injection and maintaining of the normal auricular shape are considered as ＂cure＂ ; those remain having minor auricular deformity 6 months post-operation with no recurrence and needing further treatment are considered as ＂effective＂. Results The therapeutic period for 83 patients was 2 -26 months （mean： 7 months）. The patient follow-ups were 0 - 49 months （ mean ： 9 months） after withdrawing drug injection. There were 39 cured cases （47. 0% ） and 44 effective cases （53%）. The total effective rate was 100%. Normal auricular shapes were achieved in 77 cases （92. 7% ）. Conclusion Surgical removal of auricular keloid followed by intralesional injection of low-dose 5-Fu and corticosteroids is an effective method to treat auricular keloid and prevent its relapse.
出处
《中华医学杂志》
CAS
CSCD
北大核心
2009年第16期1102-1105,共4页
National Medical Journal of China
