瘢痕疙瘩的光电治疗

Treatment of Keloid Using Light-,Laser- and Energy-Based Devices

皮肤瘢痕疙瘩是以真皮内成纤维细胞过度增生、细胞外基质大量沉积、表皮结构异常为特点的皮肤纤维增生性疾病。其病因不清,临床上缺乏特异性的治疗手段。传统的治疗方法有外科手术、冷冻、压迫疗法、局部注射药物(激素、5-Fu等),但效果均不尽如人意。近年来,随着激光理论及技术的完善,光电治疗越来越多地应用于瘢痕的治疗,尤其是IPD/DPL、PDL等技术,可选择性作用于瘢痕疙瘩中毛细血管内的血红蛋白损伤血管内皮细胞,从而引起血管闭塞,起到使瘢痕组织"褪红"的效果,结合其他瘢痕治疗手段,可较好地抑制瘢痕疙瘩的生长。其他作用于瘢痕疙瘩基质的光电治疗手段,由于有刺激瘢痕疙瘩进一步增生的风险,临床上并不建议使用。

Keloid is a hyperplastic skin disease characterized by excessive proliferation of fibroblasts, large amount of extracellular matrix deposition and abnormal epidermal structure. Keloid has an unclear etiology, and lack of specific treatment in clinic. The common treatments include surgical operation, cryotherapy, compression therapy, local injection of drugs （corticosteroids, 5-Fu, etc.）, but the effects are not satisfactory. In recent years, the use of light-, laser- and energy- based devices for treatment of multiple dermatological conditions has become more widespread, with treatment of keloids proving no exception. IPD/DPL, PDL, which can selectively absorbed by the hemoglobin in the capillary of keloid, can damage the vascular endothelial cells, thus causing the blood tube occlusion and the scar tissue shrink. Combined with other scar treatments, IPD/DPL, PDL have a synergistic effect on anti -keloids. Other phototherapeutic treatments are not recommended for clinical use due to the risk of further scarring of keloids.