超脉冲CO_(2)点阵激光联合强脉冲光治疗深Ⅱ度烧伤后瘢痕的效果分析

Analysis of the Effect of Ultra Pulsed CO_(2) Point Array Laser combined with Intense Pulsed Light on Scars after Deep second Degree Burn Injury

目的深Ⅱ度烧伤患者经治疗后均遗留不同程度的瘢痕,探讨早期采用超脉冲二氧化碳(CO_(2))点阵激光联合强脉冲光治疗对瘢痕色泽、颜色、厚度、柔软度、粗糙度、血管分布等临床影响。方法选取佛山市高明区人民医院烧伤整形科室收治的自2018年1月-2019年6月的50例深Ⅱ度烧伤患者做为研究对象,随机数字表法分为对照组(烧伤创面愈合2周后开始强脉冲光治疗,每4周1次,连续治疗3次,n=25)、研究组(在对照组患者基础上,待强脉冲光治疗结束1个月后,开始行超脉冲CO_(2)点阵激光治疗,每3个月1次,连续治疗3次,n=25),治疗后随访3个月。分别采用患者评估量表(PSAS),观察者评估量表(OSAS)、温哥华瘢痕评估量表(VSS)评价患者瘢痕恢复情况;比较临床治疗有效率。结果治疗前,两组间PSAS、OSAS、VSS评分比较无统计学差异(P>0.05);治疗结束随访3个月后,两组患者PSAS、OSAS、VSS评分均低于治疗前(P<0.05),且研究组患者上述评分较对照组降低更显著(P<0.05)。研究组患者临床治疗总有效率高于对照组(P<0.05)。结论针对深Ⅱ度烧伤患者愈合2周后遗留的瘢痕,先进行3次强脉冲光治疗后,间隔1个月,再联合3次超脉冲CO_(2)点阵激光治疗,可更好地减轻瘢痕色素沉着、使瘢痕表面更柔软、降低瘢痕的厚度,从而有效提高疗效。

Objective All patients with deep second degree burn injury leave scars of different degrees after treatment,in order to explore the early use of ultra pulsed carbon dioxide(CO_(2))lattice laser combined with strong pulse light treatment on scar color,color,thickness,softness,roughness,vascularity and other clinical effects.Methods A total of 50 patients with deep second degree burns from January 2018 to June 2019 who were admitted to the burn plastic Department of our hospital were selected as study subjects,and randomly divided into control group(burn wound healing began after 2 weeks of intense pulsed light treatment,every 4 weeks for 3 consecutive treatments,n=25),study group(on the basis of control patients,1 month after the end of intense pulsed light treatment,Treatment with an ultra pulsed CO_(2)point array laser was started,1 every 3 months for 3 consecutive sessions,n=25),and the patients were followed for 3 months after treatment.The patient assessment scale(PSAs),observer assessment scale(OSAS)were used.The Vancouver Scar Assessment Scale(VSS)assessed scar recovery in our patients.Clinical treatment response rates were compared.Results Before treatment,there were no significant differences in PSAs,OSAS,VSS scores between the two groups(P>0.05);At the end of treatment follow-up,3 months after treatment,the PSAs,OSAS,VSS scores of the study patients were lower than before treatment(P<0.05),and the above scores of the study patients were reduced more significantly than those of the control patients(P<0.05).The total effective rate of clinical treatment for patients in the study group was higher than that in the control group(P<0.05).Conclusion In view of the scar that remains after 2 weeks of healing in deep second degree burn patients,3 sessions of intense pulsed light therapy followed by 1 month interval combined with 3 sessions of ultra pulsed CO_(2)lattice laser therapy can better reduce scar pigmentation,make the scar surface softer and reduce the thickness of the scar,thus effectively improving the efficacy.