脉冲染料激光对皮肤缝合瘢痕的改善作用

Effects of pulse dye laser on cosmetic suturing scar

目的观察595nm脉冲染料激光对皮肤缝合术后瘢痕的改善作用。方法对20例面部手术皮肤缝合的患者，随机分为观察组和对照组，每组各10例，对于每例患者的术后瘢痕按温哥华瘢痕量表（Vancouver scar scale，VSS）进行术后评分；观察组采用595nm脉冲染料激光治疗3次，对照组不采取任何治疗，3次治疗结束后1个月，随访两组的瘢痕情况并按温哥华瘢痕量表评分，所获取的术前、术后瘢痕评分分别采用横向及纵向配对t检验评估临床疗效。结果对照组前后VSS评分分别为（3．80±1．48）分和（5．20±2．66）分，差异无统计学意义（P〉0．05），而观察组前后VSS评分分别为（4．10±1．20）分和（2．80±1．23）分，差异有统计学意义（P〈O．05），经过激光治疗后瘢痕发红明显改善，高度及硬度增加不明显。此外，观察组与对照组治疗前VSS评分差异无统计学意义[（4．10±1．20比3．80±1．48，P〉0．05）]；而术后两组VSS评分相比，差异有统计学意义[（2．80±1．23）分比（5．20±2．66）分，P〈0．05）]。结论皮肤缝合术后早期应用595nm脉冲染料激光治疗可有效改善瘢痕外观及质地。

Objective To evaluate the effects of the pulsed-dye laser （PDL） at a wave length of 595 nm in treatment of scar after cosmetic suturing. Methods Twenty patients after cosmetic suturing were randomly assigned to the treatment group and control group. Each group had ten patients. The scar of patient was evaluated with the Vancouver scar scale （VSS）. The treatment group was treated with 595 nm PDL for three times, and the control group did not receive any treatment. Follow-up was arranged at one mouth after the last treatment. Acquired score was compared with paired T-test trans- versely and longitudinally. Results Pre-operation VSS was 3.80 ± 1.48 and post-operation VSS was 5.20±2.66 in control group, which had no statistic difference （P〈0.05）. Preoperation VSS was 4.10 ± 1.20 and post-operation VSS was 2.80± 1.23 in treatment group, which showed statistic difference （P〈0.05） ; scars were much normal in treatment group, including less vasculature, more flatter and softer. VSS in the control group postoperatively had no statistic difference as compared with the treatment group （4.10±1.20 vs. 3.80±1.48, P〉0.05）. VSS in the treatment group showed significant statistic difference between pre-operation and post-operation （ 2.80 ± 1.23 vs. 5.20 ± 2.66, P 〈0.05）. Conclusions 595nm PDL is a safe and effective treatment in improving the appearance of scars after cosmetic suturing.