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瘢痕疙瘩是一种纤维增生性疾病,通常由伤口愈合异常引起,常见诱因包括手术、创伤、烧伤、痤疮、昆虫叮咬和疫苗接种等。极少数情况下,瘢痕疙瘩也可能会自发形成,通常发生在皮肤张力较高的部位,如胸骨前区、背部和颈后部[1]。瘢痕疙瘩的特征是成纤维细胞和胶原蛋白形成增加,新生血管生长,并存在大量上调的促炎细胞因子,但其形成机制尚不明确。瘢痕疙瘩在非洲、亚洲和西班牙裔的深色人种中发病率最高[2]。瘢痕疙瘩除了给患者带来美容方面的困扰,有时也会导致患者出现灼热、疼痛、瘙痒、活动受限和感觉过敏等症状。Balci等[3]的研究结果显示,有瘢痕疙瘩的患者的生活质量水平甚至与银屑病患者相同。由于瘢痕疙瘩发病机制的复杂性,治疗瘢痕疙瘩非常困难,单纯手术切除后其复发率高达45%~100%,甚至可能会导致比以前更严重的瘢痕[4]。近年来,随着核医学的蓬勃发展,手术切除瘢痕疙瘩联合术后辅助近距离放疗取得了较为显著的疗效,大大降低了瘢痕疙瘩的复发率。我们就目前主要的几种近距离放疗方案现状与进展进行综述。
近距离放疗在瘢痕疙瘩治疗中的研究进展
Research progress of brachytherapy in the treatment of keloid
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摘要: 瘢痕疙瘩是一种纤维增生性疾病,通常由伤口愈合异常引起,手术切除后极易复发。近年来,近距离放疗的应用大大降低了瘢痕疙瘩切除后的复发率,疗效显著。笔者就目前临床上常用的几种近距离放疗方法进行综述,为临床医师和相关领域科研工作者对瘢痕疙瘩治疗方案的制定提供参考。Abstract: Keloid is a fibroproliferative disease, usually caused by abnormal wound healing, and it is easy to recur after surgical resection. In recent years, the application of radioactive adjuvant therapy has greatly reduced the recurrence rate of keloids after resection. This article reviews several brachytherapy methods commonly used in clinical practice, and provides references for clinicians and researchers in related fields in the treatment of keloids.
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Key words:
- Keloid /
- Radiation, ionizing /
- Brachytherapy /
- Plastering therapy
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