面部小面积瘢痕手术切口早期应用A型肉毒毒素注射联合强脉冲光照射的临床效果

Effect of incision early combined botulinum toxin typeAinjections and intense pulsed light treatment for facial small area scar surgery

目的探讨面部小面积瘢痕切除术后切口早期应用A型肉毒毒素注射联合强脉冲光治疗的临床价值。方法将我院行面部小面积瘢痕切除术的228例患者随机等分为试验组和对照组,行常规切除改形术后,两组除均按时换药拆线、外用硅凝胶制剂等抗瘢痕增生的措施治疗外,试验组于拆线时切口内一次性注射A型肉毒毒素,术后1、2、3个月每月给予强脉冲光照射治疗1次。结果试验组切口红肿时间缩短、瘢痕增生程度较轻,色素沉着较少,没有明显的瘢痕疙瘩形成;而对照组切口红肿时间较长、瘢痕增生程度较重,色素沉着较多,3例在下颌部位发生瘢痕疙瘩;试验组术后1年的治愈率和有效率分别为91.22%、98.25%,对照组的术后1年治愈率和有效率分别为63.16%和92.98%,两组的治愈率之间差别具有统计学意义(P<0.05)。结论术后切口早期应用A型肉毒毒素注射联合强脉冲光治疗面部小面积瘢痕,可显著提高手术治愈率,且具有简单易行、不良反应低的特点。

Objective To explore the clinical value of combined botulinum toxin type A injections and intense pulsed light therapy on facial scar resection of early incision. Methods 228 patients of our hospital for facial small area scar excision were randomly divided into experimental and control groups, all of them in accordance with the principle of routine removal of orthopedic reshaping surgery firstly, in addition to the two groups were given time after dressing stitches, then anti-scar treatment of topical silicone gel preparations were done, experimental group also in stitches incision disposable injection of botulinum toxin type A, three times intense pulsed light irradiation were given after 1, 2, 3 month. Results Experimental group wound swelling time was shortened, scar a lesser extent, less pigmentation, there was no obvious keloid formation, while the control group incision swelling longer, more severe scarring, pigmentation and more, three cases occurred keloid in the jaw area. Experimental group cure rate and effective rate were as follows： 91.22% and 98.25%, and in the control group cure rate and effective rate were as follows 63.16% and 92.98%, those cure rates were significant difference（P〈0.05）. Conclusion Early incision combined with botulinum toxin type A injections and intense pulsed light treatment of facial small area scarring, which can significantly improve the cure rate, and has a simple, low side effects features.