皮损内注射曲安奈德结合CO_(2)点阵激光对增生性瘢痕患者瘢痕厚度与VAS评分的影响

Effects of intralesional injection of triamcinolone acetonide combined with CO_(2) lattice laser on scar thickness and VAS score in patients with hypertrophic scar

目的探讨皮损内注射曲安奈德结合CO_(2)点阵激光治疗增生性瘢痕的效果。方法选取2018年11月至2020年10月我院接收的80例增生性瘢痕患者为研究对象,依据患者入院编号的奇偶性将其分为对照组与研究组,每组40例。对照组实施单纯的CO_(2)点阵激光治疗,研究组在对照组的基础上实施皮损内注射曲安奈德治疗。比较两组的临床疗效、实验室指标及瘢痕、疼痛、瘙痒评分。结果研究组的治疗总有效率显著高于对照组(P<0.05)。治疗后,两组的血管内皮生长因子(VEGF)、表皮细胞生长因子(EGF)、转化生长因子β_(1)(TGF-β_(1))水平均明显低于治疗前,且研究组低于对照组(P<0.05)。治疗后,两组的厚度、色泽、血管分布、柔软度评分及视觉模拟评分法(VAS)、12项目瘙痒严重程度评估量表(12-PSS)评分均明显低于治疗前,且研究组低于对照组(P<0.05)。结论皮损内注射曲安奈德结合CO_(2)点阵激光治疗增生性瘢痕的效果显著,可降低VEGF、EGF、TGF-β_(1)水平,消减瘢痕厚度,减轻疼痛、瘙痒症状。

Objective To investigate the effects of intralesional injection of triamcinolone acetonide combined with CO_(2) lattice laser on scar thickness and VAS score in patients with hypertrophic scar.Methods Eighty patients with hypertrophic scars admitted in our hospital from November 2018 to October 2020 were selected as the research objects,and the patients were divided into control group and study group according to the parity of admission numbers,with 40 cases in each group.The control group was treated with CO_(2) lattice laser,and the study group was treated with intralesional injection of triamcinolone acetonide on the basis of the control group.The clinical efficacy,laboratory indexes and scores of scar,pain and itch were compared between the two groups.Results The total effective rate of treatment in the study group was significantly higher than that in the control group(P<0.05).After treatment,the levels of vascular endothelial growth factor(VEGF),epidermal growth factor(EGF)and transforming growth factor-β_(1)(TGF-β_(1))in the two groups were significantly lower than those before treatment,and those in the study group were lower than the control group(P<0.05).After treatment,the thickness,color,blood vessel distribution and softness scores,and Visual Analogue Scale(VAS)and 12-Item Pruritus Severity Scale(12-PSS)scores of the two groups were significantly lower than those before treatment,and those of the study group were lower than the control group(P<0.05).Conclusion Intralesional injection of triamcinolone acetonide combined with CO_(2) lattice laser in the treatment of hypertrophic scar has a significant effect,which can decrease VEGF,EGF and TGF-β_(1) levels,and reduce scar thickness,pain and itch symptoms.