CO_2点阵激光联合外用抗HS药治疗增生性瘢痕远期疗效观察

Long-term Effect of CO_2 Laser Combined with Anti-HS Drugs for Hypertrophic Scar

目的:观察CO_2点阵激光联合外用抗HS药治疗增生性瘢痕的远期疗效。方法:选取90例增生性瘢痕患者,按随机数表法分为观察组与对照组,各45例。对照组仅外用复方丙酸氯倍他索软膏,观察组在对照组基础上联合CO2点阵激光治疗。采用温哥华瘢痕量表(VancouverScarScale,VSS)评估两组治疗前、治疗后3个月的瘢痕情况,比较两组总有效率、不良反应与随访1年的复发率。结果:两组治疗后3个月的VSS总评分均较治疗前显著减小(P<0.05)。观察组治疗后3个月的VSS总评分为(3.01±0.65)分,显著低于对照组(4.22±0.79)分(P<0.05);观察组总有效率为88.89%,显著高于对照组71.11%(P<0.05)。观察组与对照组不良反应总发生率分别为16.28%与11.36%,差异无统计学意义(P>0.05);观察组随访1年的复发率4.65%,显著低于对照组25.00%(P<0.05)。结论:CO2点阵激光联合复方丙酸氯倍他索软膏治疗增生性瘢痕可有效修复患者瘢痕情况,提高疗效,且复发率更低,不良反应无明显增加。

Objective To observe the long-term curative effect of CO2 laser combined with anti-HS drugs for hypertrophic scar. Methods The total of 90 patients with hypertrophic scars were selected and divided into observation group and control group according to the random number table method, with 45 cases in each group. The control group was treated with external clobetasol propionate ointment only, and the observation group was combined with CO2 laser on the basis of the control group. The Vancouver Scar Scale （VSS） was used to evaluate the scars before and after treatment for 3 months in both groups. The total effective rate, the adverse reactions and recurrence rate during 1-year follow-up were compared between two groups. Results The VSS total score at the 3 months after treatment in both group was signifcantly lower than before treatment （P〈0.05）. The total VSS score in the observation group at 3 months after treatment was （3.01±0.65） points, which was signifcantly lower than （4.22±0.79） points in the control group （P〈0.05）. The total effective rate in the observation group was 88.89%, which was signifcantly higher than 71.11% in the control group （P〈0.05）. The total incidence of adverse reactions in the observation group and the control group were 16.28% and 11.36%, respectively, the difference was not statistically signifcant （P〉0.05）. The recurrence rate during the follow-up one year in the observation group was 4.65%, signifcantly lower than the control group 25.00% （P〈0.05）. Conclusion The CO2 laser combined with compound clobetasol propionate ointment can effectively repair scars in patients with hypertrophic scars,improve curative effect, lower recurrence rate and no obvious increase in adverse reactions. It is an ideal treatment plan.