湿润烧伤膏涂抹联合CO2点阵激光对烧伤瘢痕患者创面愈合时间及VSS评分的影响

Effect of moist burn ointment combined with CO2 lattice laser on wound healing time and VSS scorein patients with burn scars

目的 探讨湿润烧伤膏涂抹联合CO2点阵激光在烧伤瘢痕患者中的应用效果.方法 选取2018年6月~2019年7月我院烧伤瘢痕患者68例,简单随机化法分为观察组(n=34)、对照组(n=34).对照组予以CO2点阵激光治疗,观察组予以湿润烧伤膏涂抹联合CO2点阵激光治疗.比较两组疗效、创面愈合时间、温度恢复正常时间、细菌转阴时间、治疗前后温哥华瘢痕量表(VSS)评分、瘙痒语言评分量表(VRS)评分、瘢痕血流值、创面血管内皮生长因子(VEGF)、表皮细胞生长因子(EGF)、基质细胞衍生因子-1α(SDF-1α)水平、色素沉着率.结果 观察组总有效率97.06%(33/34)高于对照组76.47%(26/34,P<0.05);观察组创面愈合时间、温度恢复正常时间、细菌转阴时间短于对照组(P<0.05);治疗后观察组厚度、柔软度、色泽、血管分布评分、VRS评分、瘢痕血流值低于对照组(P<0.05);治疗后观察组创面VEGF、EGF、SDF-1α水平高于对照组(P<0.05);观察组色素沉着率2.94%(1/34)低于对照组26.47%(9/34,P<0.05).结论 湿润烧伤膏涂抹联合CO2点阵激光治疗烧伤瘢痕效果显著,能通过调节创面VEGF、EGF、SDF-1α水平有效减轻瘢痕状况,缓解瘙痒症状,减少瘢痕血流,缩短创面恢复时间.

Objective To investigate the application of moist burn ointment combined with CO2 lattice laser in patients with burn scars.Methods Sixty-eight patients with burn scars in our hospital from June 2018 to July 2019 were selected and divided into observation group(n=34)and control group(n=34)by simple randomization method.The control group was treated with CO2 lattice laser,and the observation group was treated with moist burn ointment combined with CO2 lattice laser.The efficacy,wound healing time,temperature return to normal time,the time of bacterial conversion to negative,Vancouver Scar Scale(VSS)score,pruritus language scale(VRS)score,scar blood flow value,wound vascular endothelial growth factor(VEGF),epidermal cell growth factor(EGF),stromal cell derived factor-1α(SDF-1α)levels before and after treatment,and pigmentation rate were compared between the two groups.Results The total effective rate in the observation group was 97.06%(33/34)higher than that in the control group 76.47%(26/34,P<0.05);the wound healing time,temperature returned to normal time,and bacteria turned negative in the observation group were shorter than those in the control group(P<0.05);after treatment,the thickness,softness,color,blood vessel distribution score,VRS score,and scar blood flow value of the observation group were lower than those of the control group(P<0.05);after treatment,the levels of VEGF,EGF,and SDF-1αin the observation group were higher than those in the control group(P<0.05);the pigmentation rate in the observation group was 2.94%(1/34)lower than that in the control group 26.47%(9/34,P<0.05).Conclusion The application of MEBO in combination with CO2 lattice laser in the treatment of burn scars is significant,which can effectively reduce the scar condition by adjusting the levels of VEGF,EGF,and SDF-1αin the wound,relieve itching symptoms,reduce scar blood flow,and shorten the wound recovery time.