耳垂瘢痕疙瘩综合治疗的疗效及生存质量调查

张谊; 张璃; 林孝华; 李智铭; 张启瑜

doi:10.16766/j.cnki.issn.1674-4152.2017.04.028

耳垂瘢痕疙瘩综合治疗的疗效及生存质量调查

doi: 10.16766/j.cnki.issn.1674-4152.2017.04.028

1. 温州医科大学第一附属医院皮肤科, 浙江温州 325000;
2. 温州医科大学第一附属医院肝胆外科

基金项目:

浙江省卫生厅资助项目(2015KYB244)

浙江省教育厅高教重中之重学科(2008-255)

详细信息

通讯作者:
林孝华,E-mail:wzlinxiaohua@163.com

中图分类号: R751.05;R764.81
计量
- 文章访问数: 55
- HTML全文浏览量: 13
- PDF下载量: 0
- 被引次数: 0
出版历程
- 收稿日期: 2016-04-13
- 网络出版日期: 2022-08-06

Clinical outcome and quality of life of patients with earlobe keloids after a multimodal therapy approach

Department of Dermatology, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang 325000, China

摘要

摘要: 目的研究手术切除联合磁铁片加压及曲安奈德针注射治疗耳垂瘢痕疙瘩的疗效及治疗后生质存量的改善情况。方法 56例(64侧)患者行手术切除耳垂瘢痕疙瘩,缝合后即向创面内注射曲安奈德混悬液20~40 mg,随后每2周注射1次,共5次,拆线后局部用磁铁片加压治疗,每天8 h并保持6个月,随访12~36个月,随访结束后进行生存质量调查。结果 4例失访,随访52例(59侧)中有5例(6侧)复发,复发率为10.2%,术后平均复发时间为(9±9)个月。治疗后瘙痒、疼痛显著减轻,而复发组与未复发组比较治疗前、后疼痛和瘙痒评分差异均无统计学意义;治疗后生存质量显著提高,GBI总分为29.98±16.97,复发组GBI总分为18.13±11.13,未复发组GBI总分32.14±17.04,较复发组显著提高(P<0.05);复发组瘢痕疙瘩体积为(5.53±4.88)cm³,未复发组为(5.32±3.87) cm³,2组比较差异无统计学意义。有家族史组复发率为15.0%,无家族史组为15.6%,2组比较差异无统计学意义;满意率为90.4%,满意度评分为(3.54±0.73)分,未复发组满意度评分(3.66±0.57)较复发组(2.88±1.13)高(P<0.05);磁片佩戴的舒适性评分为3.62±0.53,未复发组评分(3.70±0.46)较复发组(3.13±0.83)高(P<0.05)。结论手术切除联合磁铁片加压及曲安奈德注射治疗耳垂瘢痕疙瘩安全有效,可以显著减少耳垂瘢痕疙瘩复发率,并显著改善患者生存质量。
- 瘢痕疙瘩 /
- 耳垂 /
- 联合治疗 /
- 生存质量
Abstract: Objective To investigate the clinical effects of early postoperative magnet application and triamcinolone acetonide injection in patients with earlobe keloids after surgery,and the role in improving the quality of life. Methods A total of 56 patients with 64 earlobe keloids were enrolled in a prospective cohort study.All the patients underwent intramarginal keloid excision followed by triamcinolone acetonide injection (20-40 mg,one time 1 every 2 weeks,total 5 times) and post-excisional pressure therapy with magnetic disks (8 hours every day for total 6 months).The follow up was 12 to 36 months.The quality of life of patients evaluated. Results Four patients (with 5 keloids) were lost in the follow-up.6 of 59 keloids recurred with a rate of 10.2% and 1 mean time of 9±9 months.The itching and pain after the treatment were improved significantly.The score for the itching and pain both before and after the treatment were not statistically significant.The quality of life after the treatment was improved,the mean GBI score was 29.98±16.97,18.13±11.13 in the recurrence group and 32.14±17.04 in the non-recurrence group (P<0.05).The size of the keloids with a relapse was (5.53±4.88) cm³,without a relapse was (5.32±3.87) cm³,there was no statistical significant between the two groups (P>0.05).The relapse rate in patients with a positive family history was 15% and in patients without a positive family history was 15.6%,the different was not significant.The mean score for satisfaction was 3.54±0.73 and the satisfaction rate was 90.4%,the score for satisfaction in the recurrence group was 2.88±1.13,which was lower than 3.66±0.57 in the non-recurrence group (P<0.05);The mean score for the comfortability of magnetic disk was 3.62±0.53,3.70±0.46 in the non-recurrence group which was higher than 3.13±0.83 in the recurrence group (P<0.05). Conclusion The early postoperative magnet application and triamcinolone acetonide injection in patients with earlobe keloids is effective and safe,which can reduce the relapse rate of earlobe keloid and improve the quality-of-life of patients.
- Keloid /
- Earlobe /
- Multimodal therapy /
- Quality of life