Dumurgier C, Pujol G, Chevalley J, Bassoulet H, Ucla E, Stchepinsky P
Service de Chirurgie et de Paraplégies Traumatiques, Institution Nationale des Invalides, Paris, France.
Paraplegia. 1991 Jul;29(6):390-5. doi: 10.1038/sc.1991.54.
The development of a pressure sore carcinoma in scars of spinal cord injury patients is a rare event (less than 0.5%) and occurs late (more than 30 years after the spine injury) but the prognosis is very poor. Five cases are reported and different aspects are reviewed: anamnesis, clinical features, and follow-up studies. The association of surgery and radiotherapy is usual but is not very successful. Local-regional chemotherapy and a better approach concerning immunological mechanisms may improve survival. Scar prevention and surgical management of chronic scars treated unsuccessfully by medical methods are the best means to prevent malignant changes in chronic pressure sores. Biopsy should be mandatory for all pressure sores after the first decade.
脊髓损伤患者瘢痕中发生压疮癌是一种罕见事件(少于0.5%),且发生较晚(脊柱损伤后30多年),但其预后很差。本文报告了5例病例并对不同方面进行了综述:病史、临床特征及随访研究。手术与放疗联合是常用方法,但效果不太理想。局部区域化疗以及在免疫机制方面采取更好的方法可能会提高生存率。预防瘢痕以及对经医学方法治疗失败的慢性瘢痕进行手术处理是预防慢性压疮恶变的最佳手段。对于所有病程超过十年的压疮均应进行活检。