曲安奈德联合点阵CO_(2)激光治疗增生性瘢痕的疗效观察

Effect of Triamcinolone Acetonide Combined with Fractional CO2 Laser on Hypertrophic Scar

目的探讨曲安奈德(TA)联合点阵CO_(2)激光治疗增生性瘢痕(HS)的临床疗效。方法选取2015年7月-2018年8月收治的80例HS患者,随机数字表法分为TA组(瘢痕内注射TA治疗)和联合组(瘢痕内注射TA联合点阵CO_(2)激光治疗)。对比两组治疗前后温哥华瘢痕量表(VSS)、视觉模拟疼痛量表(VAS)、瘙痒评分;对比两组临床疗效,采用列联表分析瘢痕面积与临床疗效的相关性;对比两组治疗前后血清VEGF、TGF-β1水平及不良反应发生率、满意度、复发率。结果治疗前两组VSS、VAS和瘙痒评分比较,差异无统计学意义(P>0.05);与治疗前比较,治疗后两组VSS、VAS和瘙痒评分降低,且联合组低于TA组(P<0.05);联合组临床有效率(97.50%)高于TA组(82.50%)(P<0.05),瘢痕面积与临床疗效有相关性(P<0.05);联合组不良反应发生率(10.00%)低于TA组(25.00%),满意度(92.50%)高于TA组(77.50%)(P<0.05);两组复发率比较,差异无统计学意义(P>0.05)。结论TA联合点阵CO_(2)激光可有效抑制瘢痕增生,疗效确切,不良反应少,患者满意度高。

Objective To observe the clinical effect of triamcinolone acetonide(TA)combined with lattice CO_(2) laser on hypertrophic scar(HS).Methods Eighty patients with HS from July 2015 to August 2018 were randomly divided into TA group(intra-scar injection of TA treatment)and combination group(intra-scar injection of TA combined with dot-matrix CO_(2) laser treatment).The Vancouver Scar Scale(VSS),Visual Analogue Pain Scale(VAS)and pruritus score before and after treatment were compared between the two groups.The clinical efficacy were compared between the two groups,and the correlation between scar area and clinical efficacy was analyzed by contingency table.The incidence of adverse reactions,satisfaction and recurrence rate were compared.Results There was no significant difference in the scores of VSS,VAS and pruritus between the two groups before treatment(P>0.05).Compared with before treatment,the scores of VSS,VAS and pruritus of the two groups decreased after treatment,and the combined group was lower than TA group(P<0.05).The total clinical efficacy of combined group(97.50%)was higher than that of TA group(82.50%)(P<0.05).The scar area was correlated with the clinical efficacy(P<0.05).The total incidence of adverse reactions in the combined group(10.00%)was lower than that in the TA group(25.00%),and the satisfaction rate(92.50%)was higher than that in the TA group(77.50%)(P<0.05).There was no significant difference in recurrence rate between the two groups(P>0.05).Conclusion TA combined with dot-matrix CO_(2) laser can effectively inhibit scar hyperplasia,with exact curative effect,less adverse reactions,high patient satisfaction.