超脉冲二氧化碳点阵激光联合曲安奈德湿敷对早期增生性瘢痕的疗效

Effect of super-pulsed carbon dioxide fractional laser combined with triamcinolone acetonide wet compress on early hyperplastic scars

目的探讨超脉冲二氧化碳点阵激光联合曲安奈德湿敷对早期增生性瘢痕的影响。方法将就诊的早期增生性瘢痕患者98例随机均分为观察组(超脉冲二氧化碳点阵激光联合曲安奈德湿敷)和对照组(单一超脉冲二氧化碳点阵激光治疗)。比较两组治疗后的临床疗效(皮肤修复率、治愈时长)和不良反应(色素沉着、持久性潮红、点状渗血);比较两组患者治疗前、治疗3个月和治疗6个月后的瘢痕状况[温哥华瘢痕量表(VSS)、痤疮瘢痕评估量表(ECCA)]、瘢痕炎症水平、疼痛情况[视觉模拟评分法(VAS)]、生活质量[皮肤病生活质量指标调查表(DLQI)]。结果观察组治疗后的皮肤修复率高于对照组(P<0.05);而观察组治疗后的治愈时长和总不良反应率低于对照组(P<0.05)。治疗3个月和6个月后,两组患者的瘢痕状况、瘢痕炎症因子水平、VAS和DLQI评分均较治疗前下降,且观察组低于对照组(P<0.05)。结论采用超脉冲二氧化碳点阵激光联合曲安奈德湿敷治疗早期增生性瘢痕患者,能够有效改善早期增生性瘢痕的状况,减轻瘢痕炎症因子水平和疼痛情况,提高生活质量。

Aim To explore the effect of super-pulsed carbon dioxide fractional laser combined with triamcinolone acetonide wet compress on early hyperplastic scars.Methods Patients with early hyperplastic scars were selected and randomly divided into observation group(super-pulsed carbon dioxide fractional laser combined with triamcinolone acetonide wet compress)and control group(single super-pulsed carbon dioxide fractional laser therapy)according to the odd-even number method.The clinical efficacy(skin repair rate,healing time)and adverse reactions(pigmentation,persistent flushing,punctate bleeding)after treatment and scar status[Vancouver scar scale(VSS),estimate clinical cicatrix acne(ECCA)],scar inflammation level,pain status[visual analogue scale(VAS)]and quality of life[Dermatology Life Quality Index(DLQI)]before treatment and after 3 months and 6 months of treatment were compared between the two groups of patients.Results The skin repair rate in observation group after treatment was higher than that in control group(P<0.05).The healing time and total adverse reaction rate in observation group were shorter or lower compared with those in control group after treatment(P<0.05).After 3 and 6 months of treatment,the scar status,scar inflammation level,VAS score and DLQI score of patients in both groups were reduced compared with those before treatment,and the indicators in observation group were lower than those in control group.Conclusion Super-pulsed carbon dioxide fractional laser combined with triamcinolone acetonide wet compress can effectively improve the early hyperplastic scar status,relieve the scar inflammation level and pain status,and enhance the quality of life in patients with early hyperplastic scars.