中国现代医生2025年1月第63卷第2期·论著·
瘢痕疙瘩术后放疗的疗效及影响因素分析
周笑笑，吴冬梅，田玉龙，段清源，李敏杰
1
郑州大学第五附属医院放疗科，河南郑州450052
[摘要]目的探讨瘢痕疙瘩术后不同时间开始20Gy/5次大分割放疗的疗效并分析影响疗效的因素。方法选取2021年1
月至2023年6月于郑州大学第五附属医院接受术后20Gy/5次放疗方案的76例患者作为研究对象，共计瘢痕疙瘩100
处，根据是否复发将瘢痕疙瘩分为有效组（n=79）和复发组（n=21）。定期随访并记录患者放疗后的治疗效果、不良反
应发生情况，采用多因素Logistic分析瘢痕疙瘩患者复发的影响因素。结果多因素Logistic回归分析发现术后放疗时间、
瘢痕切口长度与治疗后复发有关，术后7h内放疗是治疗后复发的独立危险因素（OR1，P=0.022），瘢痕切口≤5cm是
治疗后复发的独立保护因素（OR1，P=0.028）。结论手术切除结合大分割放射治疗防治瘢痕疙瘩复发有效，术后7~48h
放疗的复发率相对最低。
[关键词]瘢痕疙瘩；放射治疗；复发；疗效
[中图分类号]R619.6；R815.2[文献标识码]A[DOI]10.3969/j.issn.1673-9701.2025.02.003
Analysisoftheefficacyandinfluencingfactorsofradiotherapyafterkeloid
surgery
ZHOUXiaoxiao,WUDongmei,TIANYulong,DUANQingyuan,LIMinjie
DepartmentofRadiotherapy,theFifthAffiliatedHospitalofZhengzhouUniversity,Zhengzhou450052,Henan,China
[Abstract]ObjectiveToexploretheefficacyofhypofractionatedradiotherapyatdifferenttimeintervalsaftersurgeryforkeloid,
andtoanalyzethefactorsaffectingtheefficacy.MethodsAtotalof76patientswhounderwent20Gy/5postoperative
radiotherapyregimenintheFifthAffiliatedHospitalofZhengzhouUniversityfromJanuary2021toJune2023wereselectedas
studysubjects,andatotalof100keloidsweredividedintoeffectivegroup(n=79)andrecurrencegroup(n=21).Regular
follow-upandrecordofthepatientsafterradiotherapytreatmenteffectandadverseeffects,andmultivariateLogisticwasusedto
analyzefactorsofrecurrenceinkeloidpatients.ResultsMultivariateLogisticregressionanalysisfoundthatpostoperative
radiotherapytimeandscarincisionlengthwererelatedtorecurrenceaftertreatment,radiotherapywithin7hofsurgerywas