| 牛大伟,韩志新,李振超,樊昌伟,张红鸽.31 例烧伤后瘢痕癌患者的临床治疗分析[J].中国烧伤创疡杂志,2021,(4):291~295. |
| DOI： |
| 中文关键词: 烧伤 瘢痕癌 手术 皮瓣移植术 |
| 英文关键词:Burns Scar cancer Surgery Skin flap transplantation |
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| 中文摘要: |
| 【摘要】 目的 分析烧伤后瘢痕癌的临床特征，探讨瘢痕癌的防治方法。方法 回顾性总结分析2009年1
月至2019年1月安阳市人民医院收治的 31例烧伤后瘢痕癌患者性别、发病年龄、潜伏期、病变部位、院前就诊次数、院前诊断、临床表现、病理特征、治疗方式及预后等临床资料，探讨瘢痕癌的防治方法。结果 31 例瘢痕癌患者中，男性 23 例、女性 8 例，发病年龄为 (59. 2 ± 15. 7) 岁，潜伏期为 (31. 7 ± 19. 1) 年，发病部位为躯干部 2 例、腘窝部 8 例、小腿部 13 例、足部 8 例，院前正规就诊次数为 (1. 0 ± 1. 3) 次，院前诊断为皮肤溃疡 19 例、皮下异物1 例、皮肤结核2 例、鳞状细胞癌7 例、基底细胞癌2 例，病理检查结果显示为鳞状细胞癌Ⅰ级 22 例、鳞状细胞癌Ⅱ级 4 例、基底细胞癌Ⅰ级 5 例。所有患者均在全身麻醉下实施手术切除治疗，术后行局部放射治疗者 6 例；出院后随访 3 个月 ~ 10 年，7 例患者于 3 年内复发 (均为术后未行局部放射治疗者，其中 5 例患者再次入院治疗后未再复发，2 例患者未再次治疗, 分别于复发后 1. 5 年与 2 年时死亡)，其余患者均未复发。结论 早期积极处理烧伤后瘢痕溃疡创面是预防烧伤后瘢痕癌的根本，早期病理检查、早期手术治疗是诊治烧伤后瘢痕癌的关键，术后配合放射治疗是降低瘢痕癌复发的必要手段。 |
| 英文摘要: |
| 【Abstract】 Objective To analyze the clinical features of postburn scar cancer and explore how to prevent and treat it. Methods Clinical data of 31 patients with postburn scar cancer, admitted to The People’s Hospital of Anyang City from January 2009 to January 2019, were retrospectively summarized and analysed, including their gender, onset age, incubation period, diseased region, number of pre?hospital visits, pre?hospital diagnosis, clinical manifestation, pathological features, treatment and prognosis. Methods of prevention and treatment of scar cancer were discussed in this study. Results Of the 31 patients with scar cancer, 23 were males, 8 females, their onset age was (59. 2 ± 15. 7) years old and incubation period was (31. 7 ± 19. 1) years. In terms of diseased region, 2 cases were in trunk, 8 cases in popliteal space, 13 cases in calf and 8 cases in foot. The number of pre?hospital visits was (1. 0 ± 1. 3). The pre?hospital diagnosis found skin ulcer in 19 cases, subcutaneous foreign body in 1 case, 2 cases with skin tuberculosis, 7 cases with squamous cell carcinoma and 2 cases with basal cell carcinoma. The result of pathological examination showed 22 cases with grade I squamous cell carcinoma, 4 cases with grade II squamous cell carcinoma, and 5 cases with grade I basal cell carcinoma. All patients underwent cancerresection under general anaesthesia. Of the 31 patients, 6 cases received local radiotherapy after the resection. During the follow?up of 3 months to 10 years after discharge, 24 of the 31 patients suffered no relapse, while the other 7 cases relapsed within 3 years after discharge and all of them were those who did not receive radiotherapy after the resection. 5 of the 7 patients didn’t develop relapse again after hospital treatment, and the other two patients died respectively 1. 5 years and 2 years after the relapse without further treatment. Conclusion Early and active treatment of scar ulcer after burns is essential to prevent the formation of scar cancer, early pathological examination and early surgical treatment are key to the diagnosis and treatment of postburn scar cancer, and postoperative radiotherapy is necessary to reduce the relapse of scar cancer. |
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