超脉冲CO2点阵激光联合浅层X线治疗瘢痕疙瘩的临床疗效观察

Clinical observation on the treatment of keloid with ultra pulse CO2 lattice laser and superficial X-ray

目的探讨超脉冲CO2点阵激光联合浅层X线治疗瘢痕疙瘩的临床疗效。方法:选取笔者医院2017年4月-2019年4月期间,共345个瘢痕疙瘩患者随机分为3组,每组各115例,试验组1:为超脉冲CO2点阵激光+浅层X线照射+曲安奈德注射液治疗;试验组2为超脉冲CO2点阵激光+曲安奈德注射液治疗;对照组:曲安奈德注射液治疗。比较三组的总体有效率,治疗后的瘢痕程度(采用温哥华瘢痕量表(Vancouver scar scale,VSS)评估),临床疗效及不良事件发生率及复发率。结果:1.试验组1有效率为96.52%,高于试验组2为88.70%,高于对照组为80.87%,差异有统计学意义(P<0.05)。治疗后,三组总评分均较治疗前降低,且试验组1为(2.57±0.87)分,低于试验组2(4.54±1.39)分;对照组(5.46±1.85)分,差异有统计学意义(P<0.05)。截止至2019年11月试验组1失访3例,试验组2失访4例,对照组失访3例。试验组1随访期间复发率(10/112);试验组2随访期间复发率(14/111);均低于对照组(30/112)差异有统计学意义(P<0.05)。结论:超脉冲CO2点阵激光联合浅层X线治疗瘢痕疙瘩可以有效提高总体有效率,有效降低复发率,减少激素副作用,降低不良反应发生率,可作为瘢痕疙瘩临床治疗的理想方案。

Objective To investigate the clinical effect of superpulsed CO2 dot array laser combined with superficial X-ray in the treatment of keloid.Methods Choose the hospital during April 2017-April 2019,a total of 345 keloid were randomly divided into three groups,each group 115 examples,the experimental group 1:lattice for ultra pulse CO2 laser + shallow X-ray irradiation +triamcinolone acetonide injection treatment;Experimental group 2 was treated with ultra pulse CO2 laser and triamcinolone injection.Control group:treated with triamcinolone acetonide injection.The overall effectiveness of the three groups,post-treatment scar severity (evaluated by the Vancouver scar scale (VSS)),clinical efficacy,incidence of adverse events,and recurrence rate were compared.Results 1.The effective rate of experimental group 1 was 96.52%,higher than that of experimental group 2 (88.70%) and higher than that of control group (80.87%),the difference was statistically significant (P<0.05).After treatment,the total score of all three groups was lower than that before treatment,and that of experimental group 1 was (2.57±0.87),which was lower than that of experimental group 2 (4.54±1.39).In the control group (5.46±1.85),the difference was statistically significant (P<0.05).By November 2019,there were 3 cases lost to follow-up in the experimental group,4 cases lost to follow-up in the experimental group and 3 cases lost to follow-up in the control group.Recurrence rate during the follow-up period (10/112) in the experimental group 1;Recurrence rate during follow-up period (12/111) in experimental group 2;The difference was statistically significant (P<0.05).Conclusion Super pulsed CO2 dot array laser combined with superficial X-ray can effectively improve the overall effective rate,effectively reduce the recurrence rate,reduce hormone side effects,and reduce the incidence of adverse reactions in the treatment of hypertrophic scar,which can be used as an ideal plan for the clinical treatment of keloid.