A型肉毒毒素联合超脉冲CO_(2)点阵激光治疗增生性瘢痕的临床观察

Clinical observation of botulinum toxin type A combined with ultra-pulsed CO_(2) fractional laser in the treatment of hypertrophic scar

目的 观察A型肉毒毒素联合超脉冲CO_(2)点阵激光治疗增生性瘢痕的临床疗效。方法 自2020年01月~2021年12月选取在我院整形美容科门诊诊断为增生性瘢痕的患者40例,采用随机对照单盲法,对照组采用单纯的超脉冲CO点阵激光治疗,观察组采用瘢痕内注射A型肉毒毒素联合超脉冲CO_(2)点阵激光治疗。采用温哥华瘢痕量表(VSS)对治疗前后的瘢痕进行量化评估,记录有无感染、增生加重、新生瘢痕、水泡发生、色素改变等不良反应,末次随访调查患者满意度。结果 所有患者都得到随访,时间6~12个月。治疗后,对照组VSS评分(5.45±2.74),观察组VSS评分(3.75±2.73),具有统计学差异。患者满意度,对照组不满意2例,不太满意3例,满意10例,非常满意6例;观察组不满意0例,不太满意2例,满意7例,非常满意11例,两组满意率有统计学差异。两组在治疗期间均未发现有不良反应。结论 A型肉毒毒素联合超脉冲CO_(2)点阵激光治疗增生性瘢痕的效果良好,患者满意度高,无明显不良反应。

Objective To observe the clinical efficacy of botulinum toxin type A combined with ultra-pulsed CO_(2)fractional laser in the treatment of hypertrophic scars.Methods From January 2020 to December 2021,40 patients who were diagnosed with hypertrophic scar in the outpatient department of plastic surgery in our hospital were selected.The randomized control single-blind method was used.The control group was treated with ultra-pulsed CO_(2)fractional laser alone,and the observation group was treated with intrascar injection of botulinum toxin type A combined with ultra-pulsed CO_(2)fractional laser.The Vancouver Scar Scale (VSS) was used to quantitatively evaluate the scar before and after treatment,and recorded whether there were any adverse reactions such as infection,aggravation of hyperplasia,new scar,blisters and pigment change,and investigate patient satisfaction at last follow-up.Results All patients were followed up for 6~12 months.After treatment,the VSS score of the control group was (5.45±2.74),and the VSS score of the observation group was (3.75±2.73),with statistical difference.In the control group,2 cases were dissatisfied,3 cases were not very satisfied,10 cases were satisfied,and 6 cases were very satisfied;in the observation group,0 cases were dissatisfied,2 cases were not very satisfied,7 cases were satisfied,and 11 cases were very satisfied.The satisfaction rate was statistically different.No adverse reactions were found in both groups during the treatment period.Conclusion Botulinum toxin type A combined with ultra-pulsed CO_(2)fractional laser has a good effect in the treatment of hypertrophic scar,with high patient satisfaction and no obvious adverse reactions.