自体脂肪移植辅助脉冲染料激光治疗烧伤后增生性瘢痕的疗效及对瘢痕厚度、血流灌注的影响

The effifficacy of autologous fat transplantation assisted with pulsed dye laser treatment for hypertrophic scars after burns and its impact on scar thickness and blood flflow perfusion

目的探讨自体脂肪移植辅助脉冲染料激光治疗烧伤后增生性瘢痕(Hypertrophic scar,HS)的临床效果。方法选取2019年5月-2022年5月徐州医科大学第二附属医院收治的80例烧伤后HS患者,按随机数字表法分为2组,各40例。对照组予以脉冲染料激光治疗,观察组加用自体脂肪移植辅助治疗,持续24周。比较两组临床疗效、瘢痕状况、血流灌注、瘢痕厚度、生活质量及并发症。结果观察组总有效率高于对照组,治疗后温哥华瘢痕量表(mVSS)评分中瘢痕颜色、痛感、血管、厚度、瘙痒及柔软度评分均低于对照组,差异有统计学意义(P<0.05);观察组治疗后瘢痕血流灌注量、瘢痕厚度均低于对照组,差异有统计学意义(P<0.05);观察组治疗后世卫组织生活简易量表中生理、心理、社会及环境领域评分高于对照组,差异有统计学意义(P<0.05);两组并发症相比,差异无统计学意义(P>0.05)。结论自体脂肪移植辅助脉冲染料激光可提高烧伤后HS治疗效果,降低mVSS评分,改善瘢痕厚度及血流灌注,减轻对患者生活的影响,安全可靠。

Objective To explore the clinical effffect of autologous fat transplantation assisted with pulsed dye laser in the treatment of hypertrophic scar(HS)after burn.Methods From May 2019 to May 2022,80 patients with postburn HS admitted to the Second Affiliated Hospital of Xuzhou Medical University were randomly divided into two groups,40 patients in each group.The control group was treated with pulsed dye laser,while the observation group was treated with autologous fat transplantation for 24 weeks.The clinical effifficacy,scar status,blood perfusion,scar thickness and quality of life were compared between the two groups.Results The total effffective rate of the observation group was higher than that of the control group,and the scores of scar color,pain,blood vessels,thickness,itching and softness in the Vancouver Scar Scale(mVSS)after treatment were lower than those in the control group,with statistical signifificance(P<0.05).After treatment,the average blood flflow(Qmean)and scar thickness in the observation group were lower than those in the control group,with statistical signifificance(P<0.05).After treatment,the scores of physical,psychological,social and environmental fifields in the observation group were higher than those in the control group,and the difffference was statistically signifificant(P<0.05).Conclusion Autologous fat transplantation assisted with pulsed dye laser can improve the therapeutic effffect of HS after burn,reduce mVSS score,improve scar thickness and blood perfusion,and reduce the impact on patients'lives.