摘要：目的 观察低浓度5-氟尿嘧啶(5-Fu)与糖皮质激素局部注射联合激光治疗瘢痕疙瘩的疗效及安全性.方法 瘢痕疙瘩70例,102处病灶,平均病史8.6年,平均治疗时间为10.29个月.70例瘢痕疙瘩患者108处病灶进行单纯瘢痕内注射,0.6 ml 5-Fu与5 ml曲安奈德、1 ml 2%利多卡因混合后局部注射于瘢痕全层注射,每2～4周1次,瘢痕完全萎缩后逐渐降低药物浓度并延长注射间歇期.另一组70例瘢痕疙瘩患者102处病灶将三联药物局部注射半个月后Nd:YAG激光照射,每2～4周1次.结果 在治疗6个月以上的患者中,5-氟尿嘧啶与糖皮质激素联合激光治疗瘢痕疙瘩的总有效率为97.06%,其中完全缓解者占45.10%,极大缓解者占49.02%,部分缓解者占2.94%,未缓解者为2.94%.结论 低浓度5-氟尿嘧啶与糖皮质激素局部注射联合激光治疗瘢痕疙瘩的疗效显著. Abstract： Objective To monitor the therapeutic action and security of 5-Fu and steroid injected associate with laser to keloid. Methods One hundred and two keloid focuses of 70 patients have the average 8.6 years history and the average therapy period of 10.29 months. Among them,70 patients with total 108 keloid were treated merely with intralesional injection of a mixture of 0.6 ml 5-Fu,5 ml corticosteroid and 1 ml 2% lidocaine once per 2-4 weeks. The other 70 patients with total 102 keloid around sternal area were treated with the mixture once per 2-4 weeks. And they were irradiated with apulsed Nd:YAG laser(wavelength 1064 nm)at 35-140 energy density levels after 15 days. After keloid became flattened,drug concentration was decreased with prolonged intermission of drug injection. Results The total therapy efficacy of 5-Fu associate with steroid to keloid was 97.06%. Of them, the complete remission percentage was 45.10%,the large remission percentage was 49.02%,part remission percentage was 2.94%,and the inefficacy percentage was 2.94%. Conclusions It is more effective that the combination therapy to keloid of l

关键词：低浓度 氟尿嘧啶 糖皮质激素 激光治疗 瘢痕疙瘩 

单位：山东省枣庄市立医院烧伤整形科 277102 上海第二医科大学附属第九人民医院整复外科