摘要
目的探讨瘢痕疙瘩患者手术联合电子束放射治疗后复发的影响因素以及并发症发生情况。方法回顾性分析自2017年1月至2021年5月,新疆医科大学第一附属医院整形外科采用手术联合电子束放射治疗200例瘢痕疙瘩患者的临床资料,统计治疗后的复发及并发症发生情况,通过组间比较以及多因素分析得出复发的显著性影响因素;同时分析并发症发生情况。结果200例患者中,29例患者在随访截止前复发,总复发率为14.5%。二元Logistic回归分析结果显示:家族易感人群(P=0.026,OR=3.074)、治疗前病灶严重程度(P<0.05,OR=1.100)以及总放射剂量(P=0.016,OR=0.875)是治疗后复发的显著影响因素。在随访过程中,红斑作为19.0%患者的早期并发症出现;作为远期并发症,3.5%的患者出现切口延迟愈合,26.0%的患者出现不同程度的放射性色素沉着。结论家族易感人群以及较严重的病灶是瘢痕疙瘩复发的独立危险因素。在安全剂量范围内(12~30 Gy),较高的放射剂量为保护因素,总放射剂量越高,越不容易复发。放射治疗后放射性色素沉着最常见。
Objective To explore the influencing factors of recurrence and complications in 200 patients with keloid after operation combined with electron beam radiotherapy.Methods The clinical data of 200 patients underwent operation combined with electron beam radiotherapy from January 2017 to May 2021 were retrospectively analyzed.The recurrence and complications after treatment were counted.The significant influencing factors of recurrence were obtained through inter-group comparison and multi-factor analysis.The complications were also analyzed.Results In all patients,29 recurred before the end of follow-up.The total recurrence rate was 14.5%.The results of binary logistic regression analysis showed that the family susceptible population(P=0.026,OR=3.074),the severity of lesions before treatment(P<0.05,OR=1.100)and the total radiation dose(P=0.016,OR=0.875)were the significant influencing factors of recurrence after treatment.During the follow-up,erythema occurred as an early complication in 19.0% of patients.As a long-term complication,delayed wound healing occurred in 3.5% of patients and radioactive pigmentation occurred in 26.0% of patients.Conclusion Family susceptible population and serious lesions are independent risk factors for keloid recurrence.Within the safe dose range,it is 12-30 Gy in this paper,the higher radiation dose is the protective factor.The higher the total radiation dose,the less likely it is to recurrence.Radioactive pigmentation is most common after radiotherapy.
作者
阿力亚·阿布都拉
迟宏羽
董祥林
Aliya Abudula;CHI Hongyu;DONG Xianglin(Department of Plastic Surgery,The First Affiliated Hospital of Xinjiang Medical University,Wulumuqi 83001l,China)
出处
《中国美容整形外科杂志》
CAS
2022年第11期654-658,共5页
Chinese Journal of Aesthetic and Plastic Surgery
关键词
瘢痕疙瘩
电子束放射
复发
并发症
影响因素
Keloid
Electron beam radiotherapy
Recurrence
Complications
Influencing factors
