自体脂肪移植联合脉冲染料激光治疗烧伤后增生性瘢痕效果及对患者瘢痕血流灌注的影响

Therapeutic effect of autologous fat transplantation combined with pulsed dye laser in treatment of post-burn hypertrophic scar and its influence on blood perfusion of the scar

目的:研究自体脂肪移植联合脉冲染料激光(PDL)治疗烧伤后增生性瘢痕(HS)效果及对患者瘢痕血流灌注的影响。方法:纳入烧伤后HS患者68例,根据治疗方法的不同分为PDL组和联合组,各34例。PDL组使用PDL法进行治疗,联合组联合应用自体脂肪移植和PDL。比较PDL组和联合组的治疗显效率和治疗满意度。比较两组治疗前和治疗后6个月的HS评分、瘢痕血流灌注量以及瘢痕厚度。结果:联合组的治疗显效率明显高于PDL组(P<0.05)。治疗后,两组的颜色、痛感、血管、柔软度、厚度、瘙痒和改良温哥华瘢痕量表(mVSS)总分均明显下降,其中联合组下降更明显(均P<0.05)。治疗后,两组的瘢痕血流灌注量和瘢痕厚度均明显下降,其中联合组变化更明显(均P<0.05)。联合组患者的治疗满意度明显高于PDL组(P<0.05)。结论:与PDL单用相比,自体脂肪移植联合PDL可明显提高对烧伤后HS的疗效,有助于瘢痕评分、瘢痕血流灌注以及瘢痕厚度的改善,且患者满意度高。

Objective:To study the therapeutic effect of autologous fat transplantation combined with pulsed dye laser(PDL)in treatment of post-burn hypertrophic scar(HS)and its influence on blood perfusion of the scar.Methods:According to different treatment methods,68 post-burn HS patients were divided into PDL group and combination group,with 34 cases in each group.The PDL group was treated with PDL,and the combination group was treated with autologous fat transplantation and PDL.The treatment efficiency and treatment satisfaction of the PDL group and the combination group were compared.The HS score,scar blood perfusion volume and scar thickness before and 6 months after treatment were compared between the two groups.Results:The treatment efficiency of the combination group was significantly higher than that of the PDL group(P<0.05).After treatment,the total scores of color,pain,blood vessels,softness,thickness,pruritus and mVSS of the two groups decreased significantly,and the combination group decreased more significantly(P<0.05).After treatment,the scar blood perfusion volume and scar thickness in the two groups were significantly decreased,and the changes in the combination group were more obvious(P<0.05).The treatment satisfaction of patients in the combination group was significantly higher than that of the PDL group(P<0.05).Conclusion:Compared with PDL alone,autologous fat transplantation combined with PDL can significantly improve the efficacy of post-burn HS,and contribute to the improvement of scar score,scar blood perfusion and scar thickness,and has high patient satisfaction.