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放射性溃疡严重程度分型及临床治疗分析
引用本文:杨飞,谢卫国,张伟,王德运,刘淑华,余刚,张卫东,席毛毛.放射性溃疡严重程度分型及临床治疗分析[J].组织工程与重建外科,2022(1):62-66.
作者姓名:杨飞  谢卫国  张伟  王德运  刘淑华  余刚  张卫东  席毛毛
作者单位:武汉大学同仁医院暨武汉市第三医院烧伤科
基金项目:国家自然科学基金面上项目(81772097);武汉市医学科研项目(WX20Q18)。
摘    要:目的 按照自定义分型标准,分析不同程度放射性溃疡的临床特点及治疗结果.方法 将影响放射性溃疡严重程度的主要因素按不同权重计分,分为轻、中、重3型.以此为标准,对我院2014年4月至2020年9月收治的放射性溃疡患者进行回顾性分析,对不同严重程度及不同原发疾病患者的治疗及随访结果进行分组比较.结果 共31例患者纳入本研究...

关 键 词:慢性溃疡  放射性  皮瓣  分型  标准  严重程度

Clinical analysis of the treatment and severity classification in radiation ulcer patients
Authors:YANG Fei  XIE Weiguo  ZHANG Wei  WANG Deyun  LIU Shuhua  YU Gang  ZHANG Weidong  XI Maomao
Institution:(Department of Burns,Tongren Hospital of Wuhan University&Wuhan Third Hospital,Wuhan 430060,China)
Abstract:Objective To analyze the clinical characteristics and treatment effects of different degrees radiation ulcers according to the self-defined classification standard.Methods The main factors affecting the severity of radiation ulcers were scored according to different weighting,which were defined as mild,moderate,and severe.Based on this standard,the patients of radiation ulcer admitted to our hospital from April 2014 to September 2020 were analyzed retrospectively,in addition,the treatment and follow-up results of patients with different severity and different primary diseases were grouped and compared.Results A total of 31 patients were enrolled in this study.There were 3 cases(10.7%)of mild type,12 cases(38.7%)of moderate type and 16 cases(51.6%)of severe type.Among the patients,9 cases(29.0%)were repaired with conservative treatment,14 cases(45.2%)were repaired with local pedicle flaps,and 8 cases(25.8%)were repaired with free flaps.In these three types of patients,the more severe the classification,the longer the course of the ulcer,the more flaps were used to repair,the higher the cost of treatment,and the longer the wound healing time(P<0.05).The clinical cure rates were 87.5%,100%,and 100%in the mild,moderate,and severe groups respectively,and the ulcer recurrence rates were 33.3%,25.0%,and 21.4%respectively,with no significant difference(P>0.05).The primary causes of radiotherapy included breast cancer in 12 cases(38.7%),malignant tumors of the reproductive system in 5 cases(16.1%),cutaneous squamous cell carcinoma in 4 cases(12.9%),angiopathy in 4 cases(12.9%),dermatofibrosarcoma in 3 cases(9.7%),nasopharyngeal carcinoma in 2 cases(6.5%),and lymphoma in 1 case(3.2%).The severity of ulcers varied in patients with different primary causes(P<0.05),but there was no significant difference in the clinical recovery rate and ulcer recurrence rate(P>0.05).Conclusion There are statistical differences in the ulcer course,treatment methods,wound healing time and treatment costs among patients with radiation ulcers of different severity.Moreover,this classification standard has a guiding effect on the disease judgment and clinical treatment.
Keywords:Chronic ulcer  Radioactivity  Flap  Classification  Standard  Severity
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