摘要
目的探究超脉冲二氧化碳点阵激光(UFCL)微孔透皮导入醋酸曲安奈德(TAA)治疗早期增生性瘢痕的效果。方法2016年3月至2019年3月郑州大学附属洛阳中心医院烧伤整形科收治早期增生性瘢痕患者90例,男46例、女44例,年龄18~60岁。以随机数字表法将90例患者分为研究组(30例)、对照A组(30例)、对照B组(30例)。对照A组应用UFCL治疗,对照B组采用水光注射仪导入TAA治疗,研究组予以UFCL联合TAA治疗,均治疗6个月。比较3组治疗后6个月的有效率,应用温哥华瘢痕量表(VSS)评估增生性瘢痕状态,应用视觉模拟评分法(VAS)评估治疗前、后疼痛度,以5级满意度进行患者治疗满意度主观评价。结果(1)研究组和对照组治疗早期增生性瘢痕均有效,且研究组有效率(93.3%,28/30)高于对照A组(70.0%,21/30)、对照B组(66.7%,20/30)(P<0.05)。(2)治疗前3组瘢痕色泽、厚度、柔软度、血管分布评分间差异均无统计学意义(P>0.05);治疗6个月后上述评分均较治疗前降低(P<0.05),且研究组低于对照A组、对照B组(P<0.05)。(3)3组治疗前VAS评分比较,差异无统计学意义(P>0.05);3组治疗后VAS评分均较本组治疗前降低,且研究组低于对照A组、对照B组(P<0.05);(4)治疗6个月后,研究组患者满意率高于对照A组、对照B组(P<0.05)。结论UFCL微孔透皮导入TAA能有效治疗早期增生性瘢痕,显著改善瘢痕增生状态,提高患者满意度。
Objective To investigate the effect of ultrapulse fractional carbon dioxide laser(UFCL)microporous transdermal triamcinolone acetonide acetate(TAA)in the treatment of early hypertrophic scar.Methods Ninety patients with early hypertrophic scar in Luoyang Central Hospital Affiliated to Zhengzhou University from March 2016 to March 2019 were included and randomly divided into study group(n=30),control group A(n=30)and control group B(n=30).The control group A was treated with UFCL,the control group B was treated with TAA,and the study group was treated with UFCL combined with TAA.All three groups were treated for 6 months.The effectiveness of the three groups before and 6 months after treatment was compared,the status of hypertrophic scar was evaluated by Vancouver Scar Scale(VSS),the pain degree before and after treatment was evaluated by Visual Analogue Scale(VAS),and the patients’satisfaction with the treatment was also evaluated.Results(1)The study group and the control group were effective in the treatment of early hypertrophic scar,and the effective rate of the study group was higher than that of the control group A and the control group B[93.3%(28/30)vs.70.0%(21/30)and 66.7%(20/30);all P<0.05].(2)There was no significant difference in the scores of color,thickness,softness and vascular distribution among the three groups before treatment(P>0.05).After 6 months of treatment,the scores of the three groups were lower than those before treatment(P<0.05).The scores of study group were lower than those of control group A and control group B respectively(P<0.05).(3)There was no significant difference in VAS scores among the three groups before treatment(P>0.05).The VAS scores of the three groups after treatment were lower than those before treatment,and the VAS scores in study group were lower than those in control group A and control group B(P<0.05).(4)After 6 months of treatment,the satisfaction rate of study group was higher than that of control group A and control group B(P<0.05).Conclusions UFCL microporous transdermal TAA can effectively treat early hypertrophic scar,reduce the VSS score and VAS score of hypertrophic scar,significantly improve the state of scar hyperplasia,and improve the satisfaction rate of patients,which can be widely used in clinic.
作者
李明鸣
刘林嶓
武海龙
赵哲媛
Li Mingming;Liu Linbo;Wu Hailong;Zhao Zheyuan(Department of Burn and Plastic Surgery,Luoyang Central Hospital Affiliated to Zhengzhou University,Luoyang 471099,China;Department of Plastic Surgery,First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)
出处
《中华整形外科杂志》
CSCD
2021年第6期612-618,共7页
Chinese Journal of Plastic Surgery
关键词
激光疗法
瘢痕
激光
气体
曲安奈德
联合治疗
Laser therapy
Cicatrix
Laser,gas
Triamcinolone acetonide
Combined therapy
