二氧化碳点阵激光治疗术后瘢痕的疗效及对炎症因子的影响

Therapeutic efficacy of carbon dioxide lattice laser treatment in the treatment of postoperative scars and its impact on inflammatory factors

目的探讨二氧化碳点阵激光治疗术后瘢痕的疗效及对炎症因子的影响。方法选择2019年1月至2022年1月西安宝石花长庆医院收治的102例术后瘢痕患者作为研究对象,采用随机数表法分为对照组和观察组,每组51例。对照组患者给予硅凝胶涂抹,观察组患者在对照组治疗的基础上联合二氧化碳点阵激光治疗,两个月为一个疗程,均治疗两个疗程。治疗两个疗程后比较两组患者的疗效、痂皮脱落时间及治疗前后的温哥华瘢痕评定量表(VSS)、视觉模拟疼痛(VAS)评分、白细胞介素-10(IL-10)、白细胞介素-17(IL-17)、肿瘤坏死因子-α(TNF-α)水平及简明生活质量表(SF-36)评分;术后随访6个月,比较两组患者的瘢痕复发率。结果观察组患者的治疗总有效率为92.16%,明显高于对照组74.51%,差异有统计学意义(P<0.05);治疗后,两组患者的VSS、VAS评分均降低,且观察组患者的VSS、VAS评分为(15.38±2.10)分、(1.03±0.21)分,明显低于对照组的(26.12±3.37)分、(1.89±0.33)分,痂皮脱落时间为(5.91±1.35)d,明显短于对照组的(8.26±1.61)d,差异均有统计学意义(P<0.05);治疗后;两组患者的IL-10、IL-17、TNF-α均降低,且观察组患者的上述指标分别为(8.21±1.25)ng/L、(12.09±2.10)ng/L、(23.14±3.20)ng/L,明显低于对照组的(10.52±2.21)ng/L、(16.28±1.96)ng/L、(30.21±2.58)ng/L,差异均有统计学意义(P<0.05);治疗后,两组患者的躯体功能、心理功能、社会功能、物质生活评分均升高,观察组患者的上述各项评分分别为(81.28±4.21)分、(86.21±5.42)分、(83.29±6.31)分、(85.28±6.77)分,明显高于对照组的(73.28±3.95)分、(76.30±4.92)分、(72.91±5.20)分、(74.29±6.21)分,差异均有统计学意义(P<0.05);观察组患者的瘢痕复发率为5.88%,明显低于对照组的19.61%,差异有统计学意义(P<0.05)。结论二氧化碳点阵激光治疗术后瘢痕效果理想,可减轻瘢痕症状,缓解疼痛,促进创面愈合,减少炎症反应,提高生活质量,且复发率低,具有临床推广应用价值。

Objective To explore the therapeutic efficacy of carbon dioxide lattice laser treatment in the treatment of postoperative scars and its impact on inflammatory factors.Methods A total of 102 patients with postoperative scar admitted to Gem Flower Healthcare Xi'an Changqing Staff Hospital from January 2019 to January 2022 were selected and divided into two groups using a random number table method,with 51 patients in each group.Patients in the control group were smeared with silicon gel,and those in the observation group were treated with carbon dioxide lattice laser treatment on the basis of the control group,with two months as one course of treatment,for two courses of treatment.After treatment,the efficacy and scab shedding time were compared between the two groups,as well as the Vancouver Scar Scale(VSS),Visual Analogue Scale(VAS)score,interleukin-10(IL-10),interleukin-17(IL-17),tumor necrosis factorα(TNF-α)levels,and 36-item short-form health survey questionnaire(SF-36)score before and after treatment.The patients were followed up for 6 months after surgery,and the scar recurrence rates were compared between the two groups of patients.Results The total effective rate of the observation group was 92.16%,which was significantly higher than 74.51%of the control group(P<0.05).After treatment,the VSS and VAS scores of both groups decreased,and the scores of the observation group were(15.38±2.10)points,(1.03±0.21)points,which were significantly lower than(26.12±3.37)points,(1.89±0.33)points in the control group;the scab shedding time in the observation group was(5.91±1.35)days,which was significantly lower than(8.26±1.61)days of the control group;the difference was statistically significant(P<0.05).After treatment,the levels of IL-10,IL-17,and TNF-αin both groups decreased,and the above indicators in the observation group were(8.21±1.25)ng/L,(12.09±2.10)ng/L,and(23.14±3.20)ng/L,which were significantly lower than(10.52±2.21)ng/L,(16.28±1.96)ng/L,and(30.21±2.58)ng/L in the control group,with statistically significant difference(P<0.05).After treatment,the physical function,psychological function,social function,and material life of both groups increased,and the above scores in the observation group were(81.28±4.21)points,(86.21±5.42)points,(83.29±6.31)points,and(85.28±6.77)points,which were significantly higher than(73.28±3.95)points,(76.30±4.92)points,(72.91±5.20) points, and (74.29±6.21) points in the control group, with statistically significant differences (P<0.05). Thescar recurrence rate in the observation group was 5.88%, which was significantly lower than 19.61% in the control group(P<0.05). Conclusion Carbon dioxide lattice laser treatment for postoperative scars has an ideal effect, which can alleviatescar symptoms, relieve pain, promote wound healing, reduce inflammatory reactions, improve quality of life, with alow recurrence rate. It has high clinical promotion and application value.