王宏伟 陈刚 李玄

[摘要]目的：探究手术切除联合博来霉素对耳廓瘢痕疙瘩的治疗效果。方法：选取笔者医院2015年1月-2019年1月收治的耳廓瘢痕疙瘩患者80例，随机分为对照组和研究组，各40例，对照组进行单纯的手术切除治疗，研究组采用手术切除联合博来霉素注射治疗。评估两组疗效，比较两组患者治疗前后VSS评分以及术后复发、感染等情况。结果：研究组治疗有效率为82.50%显著高于对照组（60.00%），差异有统计学意义（P<0.05）。治疗后，两组VSS评分均显著降低，且术后1个月和3个月，研究组VSS评分均显著低于对照组，差异有统计学意义（P<0.05）。研究组复发率为5.00%显著低于对照组的22.50%，差异有统计学意义（P<0.05）。研究组感染率为2.50%，对照组为10.00%，组间比较差异无统计学意义（P>0.05）。结论：手术切除联合博来霉素注射治疗对耳廓瘢痕疙瘩有着更好的治疗效果，能够减少术后复发，值得在临床中推广应用。

[关键词]瘢痕疙瘩;耳廓;手术切除;博来霉素;复发;注射治疗

[中图分类号]R619+.6    [文献标志码]A    [文章编号]1008-6455（2020）01-0008-03

Effect of Surgical Resection Combined with Bleomycin on Auricular Keloid

WANG Hong-wei1，CHEN Gang1，LI Xuan2

（1.Department of Burn Plastic Surgery;2.Department of Anesthesiology，Naval Hospital of PLA Eastern Theater Command，Zhoushan 316000，Zhejiang，China）

Abstract： Objective  To explore the effect of operation combined with bleomycin on the treatment of auricular keloid， VSS score and recurrence. Methods  80 patients with auricular keloid admitted to our hospital from January 2015 to January 2019 were randomly divided into the control group and the study group， 40 cases in each group. The control group was treated with surgical excision alone， while the study group was treated with surgical excision combined with bleomycin injection. The curative effect， VSS score before and after treatment， postoperative recurrence and infection were compared between the two groups. Results  The effective rate of the study group was 82.50%， which was significantly higher than that of the control group （60.00%）， the differences was statistically significant（P<0.05）. After treatment， the VSS scores of the two groups were significantly lower， and the VSS scores of the study group were significantly lower than that of the control group at 1 and 3 months after operation（P<0.05）. The recurrence rate of the study group was 5.00%， which was significantly lower than that of the control group （22.50%， P<0.05）. There was no significant difference in infection rate between the two groups（P>0.05）. Conclusion  Surgical excision combined with bleomycin injection has a better therapeutic effect on keloid of auricle and can reduce the recurrence of patients after operation. The combined therapy is worth popularizing and applying in clinic.

Key words： keloid; auricle; surgical resection; bleomycin; recurrence; injection therapy

耳廓瘢痕疙瘩是位于耳廓周圍的瘢痕疙瘩，由于近年来年轻女性生活行为的改变，发生耳廓瘢痕疙瘩的患者日渐增多，由于生长位置较为特殊，耳廓瘢痕疙瘩不仅影响患者生理健康，同时也会给患者带来较大的心理负担[1-2]。博来霉素在人体内能够引起DNA的断裂，在肿瘤的治疗中有着较为广泛的应用[3]，既往研究认为博来霉素能够提高瘢痕疙瘩手术切除后的治疗效果，与传统的糖皮质激素治疗相比，其治疗效果存在一定优势[4-5]。本研究旨在通过对比分析，具体分析手术切除联合博来霉素治疗耳廓瘢痕疙瘩的临床效果，观察患者复发情况。

1  资料和方法

1.1 一般资料：选取笔者医院2015年1月-2019年1月收治的耳廓瘢痕疙瘩患者80例，纳入标准：①患者的临床症状和体征符合耳廓瘢痕疙瘩的诊断标准;②对本研究中药物无过敏史者;③临床资料完整并签署知情同意书者。……