摘要
目的探讨光学疗法联合维芎瘢痕霜对烧伤后增生性瘢痕的治疗效果。方法选择2022年1月至2023年11月,烧伤后增生性瘢痕患者121例。采用随机数字表法将患者分为对照组和研究组,对照组患者60例,采用维芎瘢痕霜治疗,每日3次,4周为1个疗程,共治疗3个月,每个疗程间隔时间1周。研究组患者61例,在对照组基础上采用窄谱强脉冲光联合CO_(2)点阵激光治疗,窄谱强脉冲光治疗光参数为波长500~600 nm,脉宽12~15 ms,光斑面积3 cm^(2),能量密度6~10 mJ/cm^(2)。CO_(2)点阵激光治疗光参数为频率为200 Hz,波长为10600 nm,能量密度15~20 mJ/cm^(2),光疗治疗3次,每次治疗间隔1个月。治疗前、3个疗程治疗后1个月,采用温哥华瘢痕量表(Vancouver scar scale,VSS)、北卡罗来纳大学瘢痕量表(university of North Carolina scar scale,UNC)评估瘢痕改善情况,检测瘢痕下局部血流灌注改善,同时记录两组患者不良反应情况和患者满意度。结果3个疗程治疗后1个月,两组患者VSS评分与UNC评分,瘢痕下局部血流灌注量均低于治疗前(P<0.05),且研究组治疗3个月后VSS评分、UNC评分和瘢痕下局部血流灌注均低于对照组(P均<0.05);两组患者治疗期间局部红斑、水疱、瘙痒、色素沉着等不良反应发生率分别为10.0%和11.5%,两组比较差异无统计学意义(P>0.05);研究组患者满意度(88.5%)高于对照组(73.3%),差异具有统计学意义(P<0.05)。结论光学疗法联合维芎瘢痕霜治疗可显著减少烧伤后增生性瘢痕的色素沉着,改善瘢痕厚度、柔韧度与血流灌注,减轻瘢痕局部瘙痒、感觉异常等症状,临床疗效确切,患者满意度与治疗安全性高。
Objective To investigate the joint therapeutic effect of optical therapy and Weixiong scar cream on hypertrophic scars caused by burn.Methods Totally 121 patients with burn-caused hypertrophic scars admitted to our hospital between Jan.2022 and Nov.2023 were selected and divided into a control group(n=60)and a study group(n=61).The patients in the control group were applied Weixiong scar cream 3 times per day for 4 weeks as a course of treatment,which was carried out for 3 months at an interval of 1 week.The patients in the study group were treated jointly with narrow-band intensively-pulsed light and CO_(2)dot array laser on the basis of the treatment adopted in the control group.The light parameters of the narrow-band intensively-pulsed light were given as below:wavelength:500-600 nm,pulse width:12-15 ms,spot area:3 cm^(2) and energy density:6-10 mJ/cm^(2).The CO_(2)dot matrix laser used for the treatment had a frequency of 200 Hz,a wavelength of 10600 nm and an energy density of 15-20 mJ/cm^(2).The phototherapy was provided 3 times at an interval of 1 month.Before the treatment and 3 months after the treatment,Vancouver scar scale(VSS)and university of North Carolina scar scale(UNC)were used to evaluate the improvement of scars and detect the improvement of local blood perfusion under the scars.In addition,the adverse reactions and patients’satisfaction of the two groups were recorded.Results One month after 3 courses of treatment,the VSS score,UNC score and local blood flow perfusion under scars in both groups were lower than those before the treatment(P<0.05),and the results in the study group were lower than those in the control group after 3 courses of treatment(P<0.05).The incidences of local erythema,blister,pruritus,pigmentation and other adverse reactions in the two groups during the treatment were 10.0%and 11.5%respectively,indicating that the differences between the two groups were not significant(P>0.05).The patients’satisfaction was 88.5%in the study group and 73.3%in the control group,and the difference was statistically significant(P<0.05).Conclusions For the treatment of burn-caused hypertrophic scars,the combination of optical therapy and Weixiong scar cream will remarkably reduce pigmentation,improve the thickness,flexibility and blood perfusion of the scars and reduce the symptoms of local itching and paresthesia of the scars with definite curative effect and high patients’satisfaction and treatment safety.
作者
袁靖
王卫粮
周牮
YUAN Jin;WANG Weiliang;ZHOU Jian(Department of trauma,Daxing District People's Hospital,Beijing 102600,China)
出处
《中国激光医学杂志》
CAS
2024年第4期214-219,239,共7页
Chinese Journal of Laser Medicine & Surgery
关键词
激光
增生性瘢痕
烧伤
维芎瘢痕霜
窄谱强脉冲光
疗效
Hypertrophic scars
Burn
Weixiong scar cream
Carbon dioxide lattice laser
Narrow-spectrum intenselypulsed light
Curative effect
