内剥切并局部注射治疗耳郭瘢痕疙瘩

背景：瘢痕疙瘩是创伤后皮肤异常修复的结果，表现为过度生长且进行性增大、侵犯邻近正常皮肤组织、常扩展到原伤口范围以外，单纯手术切除后极易复发，故需结合其他方法进行综合治疗。目的：探讨耳郭瘢痕疙瘩内核剥除术后及时局部注射的临床疗效。方法：20例耳郭瘢痕疙瘩患者，采用瘢痕疙瘩核心摘除术，并分别于术后逐渐拉长间隔时间，于切口瘢痕组织内注射氟尿嘧啶或曲安奈德加利多卡因混合或单独用药，必要时按瘢痕情况偶加用适量的复方倍他米松，视瘢痕的消退情况及时调节药物的注射剂量，观察治疗12个月到24个月。结果与结论：20例患者36个耳部瘢痕，其中有1个耳部瘢痕为效果有效，35个为耳部瘢痕为治愈。随访12-24个月，均无复发，有效率为100%，其中完全治愈者97%，效果良好者3%。结果表明，瘢痕疙瘩核心切除并利用其上皮瓣覆盖整形，联合氟尿嘧啶与糖皮质激素局部注射治疗耳郭瘢痕疙瘩是安全有效的方法。

Application of striping and local injections in patients with auricle keloid

BACKGROUND：Keloids are the result of abnormal post-traumatic skin restoration, which are characterized with overgrowth and progressive enlargement, invasion of adjacent normal skin tissue, extension beyond the scope of the original wound. Given the high recurrence, treatment with surgery alone is meaningless and, therefore, comprehensive treatment of surgery and other approaches is required. OBJECTIVE：To explore the clinical curative effect of local injection after timely removal of auricle keloid core. METHODS：Twenty patients with auricle keloid were enroled. After keloid core excision, the time interval within the incision scar tissue injection of fluorouracil or triamcinolone acetonide add lidocaine or monotherapy was gradualy lengthened, and if necessary the proper amount of compound betamethasone was added according to scar conditions. The injection dose was adjusted timely based on the regression of scar. The treatment effect was observed for 12 to 24 months. RESULTS AND CONCLUSION： Of 36 auricle keloids from 20 patients, the comprehensive treatment was effective in 1 keloid, and other 35 keloids were cured. The effective rate was 100%, the completely cured rate was 97.2% and the excelent rate was 2.8%. These findings indicate that minimaly invasive excision of keloid core and the epithelial flap coverage combined with 5-fluorouracil and corticosteroid injection is a safe and effective method to treat auricle keloids.