瘢痕内切除后即时放疗治疗瘢痕疙瘩临床分析

目的：探讨瘢痕内切除后即时放疗治疗瘢痕疙瘩的临床疗效。方法：自2002年2月～2007年6月对我科收治的18例瘢痕疙瘩患者行瘢痕内切除术，术后24h内辅以6MeV高能电子束（13射线）放射治疗，连续照射每天一次连续照射4～6次，照射总剂量15～20Gy。术后平均随访36月。结果：优良10例（55．6％），显效5例（27．8％），无效3例（16．7％），总有效率83．3％。3例伤口延迟愈合（16．7％），术后出现色素沉着3例（16．7％），毛细血管轻度扩张2例（11.1％），随访期内未发生如皮肤恶性肿瘤等并发症。结论：瘢痕内切除后即时放射治疗，术后复发率低，是治疗瘢痕疙瘩较好的治疗手段。

Clinical analysis of keloids with intralesional excision and immediate postoperative adjuvant radiotherapy

Objective To evaluate the treatment results of keloids with intralesional excision and immediate postoperative adjuvant radiotherapy in the management of keloids. Methods Eighteen patients with a combined total of 21 keloids were treated with 6 MeV electron beam radiotherapy after surgical intralesional excision of the keloids. All patients received a total dose of 15-20Gy on 4-6 consecutive days beginning the day of surgery, Mean daily fractions of 300-400cGy were administered .The time interval between keloid excision and delivery of first fraction of radiotherapy was less than 24h in all case. The median follow-up was 36months. Results 10 cases were noted to have excellent result and 5 cases were good,total effective rate was 83.3% and 3 patients of recurrence was observed during this period, only a few adverse effects such as delayed wound-healing in 3 patients, hypopigmentation was observed in 3 patients （16.7%）, and telangiectasias in 2 patients （11.1%）. No severe complications or secondary malignancies were observed. Conclusions Intralesional excision of keloid and postoperative electron radiotherapy and is well tolerated and very effective in preventing keloid recurrence.