二氧化碳点阵激光结合曲安奈德导入治疗增生性瘢痕效果观察

目的评价二氧化碳点阵激光结合曲安奈德导入治疗增生性瘢痕的治疗效果。方法先用二氧化碳点阵激光治疗44例增生性瘢痕，再将曲安奈德喷洒至创面上，通过激光微孔使曲安奈德液体渗入至瘢痕组织内发挥疗效。疗效评价采用临床良好、满意和不满意或无效三级判断疗效，结合温哥华烧伤瘢痕评估标准和视觉模拟评分法，评估患者治疗前后以及治疗后与自身对照区瘢痕色泽、厚度、血管分布、柔软度及痛痒程度等改变。结果44例患者经1-3次治疗，效果良好38例，占86.36％；满意6例，占13．64％；不满意或无效0例，总有效率为100％。患者瘢痕色泽、厚度、血管分布、柔软度及痛痒程度、在治疗前、后及治疗后自身对照差异均有统计学意义（P〈0．05）。结论二氧化碳点阵激光结合导入曲安奈德对治疗增生性瘢痕疗效较好，为治疗大面积增生性瘢痕提供了一种新的治疗方法。

Objective To evaluate the elect of fractional carbon dioxide laser combined with triamcinolone acetonide importing into hyperplastic scars. Methods Fourty-four cases with hypertrophic scar were treated.Fractional carbon dioxide laser were moved back and forth on the hyperplastic scars with triamcinolone acetonide spraying on the scar surface in the meantime.So the triamcinolone acetonide could be imported into the scar through laser holes.The effect was evaluated as good, satisfied and unsatisfied or invalid.The Vancouver Scaring Criteria and Visual Analogue Scale were used to assess the scar color, thickness, vascularity softness and sufferings feeling pretherapy and post-treatment of treatment area and control area scar. Results Fourty-four cases were treated 1-3 times, including 38 cases with good result, 6 cases with effective result, no cases of invalid.The total elective rate was 100%.The scar color, thickness, vascularity softness and sufferings sufferings feeling were significantly diferent between the scar pretherapy and post-treatment, or between the treatment area and control area （ P〈0.05 ） . Conclusions Fractional carbon dioxide laser combined with importing triamcinolone acetonide into hyperplastic scars is efective.It is a new method to treat large hyperplastic scar.