Wu Xiao-Li, Gao Zhen, Song Nan, Liu Wei
Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200011, China.
Zhonghua Yi Xue Za Zhi. 2009 Apr 28;89(16):1102-5.
To investigate whether intralesional injection of low-dose 5-fluorouracil (5-Fu) and corticosteroid can increase effective rate and decrease recurrence rate of surgically removed auricular keloid.
Eighty-three patients with 166 total ear keloids were studied, including 79 keloids of helix and 87 of earlobe with an average disease history of 2.9 years. Ear piercing accounted for 92.7% for etiology. Keloids were first surgically removed in order to keep the normal auricular shape. Then intralesional injection of low-dose of 5-Fu and corticosteroid was given 3 - 4 weeks after surgery and every 4 weeks afterwards. If no recurrence, the injection was given every 2 to 3 months with gradually tapered dose. The evaluation standard includes: patients with no recurrence 6 months after stopping drug injection and maintaining of the normal auricular shape are considered as "cure"; those remain having minor auricular deformity 6 months post-surgery with no recurrence and needing further treatment are considered as "effective".
The treatment time period for 83 patients was 2 - 26 months (mean: 7 months). The patients were followed up for 0 - 49 months (mean: 9 months) after withdrawing drug injection. There were 39 cured cases (47.0%) and 44 effective cases (53%). The total effective rate was 100%. Normal auricular shapes were achieved in 77 cases (92.7%) .
Surgical removal of auricular keloid followed by intralesional injection of low-dose 5-Fu and steroid is an effective method to treat auricular keloid and prevent its relapse.
探讨病灶内注射低剂量5-氟尿嘧啶(5-Fu)和皮质类固醇激素能否提高手术切除耳廓瘢痕疙瘩的有效率并降低复发率。
对83例共166个耳部瘢痕疙瘩患者进行研究,其中79个位于耳轮,87个位于耳垂,平均病程2.9年。病因中穿耳洞占92.7%。首先手术切除瘢痕疙瘩以保持耳廓正常形态。术后3至4周进行病灶内低剂量5-Fu和皮质类固醇激素注射,之后每4周注射一次。若未复发,每2至3个月注射一次,剂量逐渐递减。评估标准包括:停药注射后6个月无复发且耳廓形态正常者视为“治愈”;术后6个月仍有轻微耳廓畸形但无复发且需进一步治疗者视为“有效”。
83例患者的治疗时间为2至26个月(平均7个月)。停药注射后随访0至49个月(平均9个月)。治愈39例(47.0%),有效44例(53%)。总有效率为100%。77例(92.7%)恢复了正常耳廓形态。
手术切除耳廓瘢痕疙瘩后病灶内注射低剂量5-Fu和类固醇激素是治疗耳廓瘢痕疙瘩并预防其复发的有效方法。