超脉冲CO_(2)点阵激光联合曲安奈德及5-氟尿嘧啶在增生性瘢痕的应用研究

Application of superpulsed CO_(2)fldot matrix laser combined with triamcinolone and 5-fluorouracil in hypertrophic scars

目的研究超脉冲CO_(2)点阵激光联合曲安奈德(Triamcinolone acetonide,TA)及5-氟尿嘧啶(5-FU)在增生性瘢痕(Hypertrophic scar,HS)的应用效果。方法选取我院HS患者112例,选例时间为2021年1月~2022年12月,随机分为对照组(n=56)和试验组(n=56)。对照组使用超脉冲CO_(2)点阵激光治疗,试验组在对照组基础上使用TA结合5-FU治疗。对比2组治疗效果、治疗前后视觉模拟评分表(visual analogue scale,VAS)、温哥华瘢痕量表(vancouver scar scale,VSS)评分及不良反应发生率。结果试验组总有效率96.43%(54/56)较对照组82.14%(46/56)高(P<0.05);治疗后与对照组比较,试验组VAS评分低(P<0.05);治疗后与对照组比较,试验组血管分布、色素沉着、瘢痕厚度与高度、柔韧度评分低(P<0.05);试验组不良反应7例(12.50%)与对照组5例(8.93%)对比无显著差异(P>0.05)。结论超脉冲CO_(2)点阵激光联合TA及5-FU应用于HS中可提升治疗效果,缓解疼痛及瘙痒症状,改善瘢痕情况,且不会增加不良反应的发生,治疗安全性良好。

Objective The purpose of this study is to explore the application effect of super-pulsed CO_(2)dot matrix laser combined with Triamcinolone acetonide(TA)and 5-fluorouracil(5-FU)in Hypertrophic scar(HS).Methods A total of 112 patients with HS in our hospital from January 2021 to December 2022 were selected and randomly divided into control group(n=56)and test group(n=56).control group received superpulse CO_(2)dot matrix laser treatment,and the test group was treated with TA combined with 5-FU on the basis of control group.The treatment effect,visual analogue scale(VAS)score,Vancouver scar scale(VSS)score and the incidence of adverse reactions were compared between the two groups before and after treatment.Results The total effective rate of the test group was 96.43%(54/56),which was higher than that of the control group(82.14%,46/56)(P<0.05).Compared with the control group after treatment,the VAS score of the test group was lower(P<0.05).Compared with the control group after treatment,the scores of vascular distribution,pigmentation,scar thickness and height,and flexibility in the test group were lower(P<0.05).There was no significant difference in the adverse reaction rate between the test group(7 cases,12.50%)and the control group(5 cases,8.93%)(P>0.05).Conclusion The application of ultra-pulsed CO_(2)fractional laser combined with TA and 5-FU in HS can improve the treatment effect,relieve pain and itching symptoms,and improve the scar situation without increasing the occurrence of adverse reactions,and the treatment is safe.