复方倍他米松联合超脉冲点阵二氧化碳激光治疗烧伤后增生性瘢痕的效果及安全性分析

Analysis of the efficacy and safety of compound betamethasone combined with ultrapulse fractional CO_(2)laser in the treatment of hypertrophic scars after burns

目的分析复方倍他米松联合超脉冲点阵二氧化碳激光(UFCL)治疗烧伤后增生性瘢痕(HS)患者的效果及安全性。方法回顾性分析2022年9月至2023年9月我院80例烧伤后HS患者资料,按不同治疗方案将采用UFCL治疗的40例患者列为对照组,将采用复方倍他米松+UFCL治疗的40例患者列为观察组。比较两组临床疗效、温哥华瘢痕量表(VSS)评分、皮肤屏障功能(表皮水分丢失量、角质层含水量、pH值)、血清肿瘤坏死因子-α(TNF-α)、颗粒蛋白前体(PGRN)、转化生长因子-β1(TGF-β1)水平及安全性。结果观察组临床总有效率92.50%(37/40)高于对照组75.00%(30/40)(P<0.05);治疗后观察组色泽、血管分布、柔软度、厚度评分及VSS总分低于对照组(P<0.05);治疗后观察组角质层含水量高于对照组,TNF-α、PGRN、TGF-β1、水分丢失量、pH值低于对照组(P<0.05);观察组不良反应发生率12.50%(5/40)与对照组7.50%(3/40)比较,无明显差异(P>0.05)。结论复方倍他米松联合UFCL治疗烧伤后HS疗效显著,可抑制纤维组织增生,减轻瘢痕程度,改善皮肤屏障功能,安全性高。

Objective To analyze the effect and safety of compound betamethasone combined with Ultrapulse fractional CO_(2)laser(UFCL)in the treatment of hypertrophic scar(HS)after burn.Methods The data of 80 patients with HS after burn in our hospital from September 2022 to September 2023 were retrospectively analyzed.According to different treatment schemes,40 patients treated with UFCL were included in the control group,and 40 patients treated with compound betamethasone+UFCL were included in the observation group.The clinical efficacy,Vancouver Scar Scale(VSS)score,skin barrier function(epidermal water loss,stratum corneum water content,pH value),and levels of serum tumor necrosis factor-α(TNF-α),Granulated protein precursor(PGRN),transforming growth factor-β1(TGF-β1)and safety were compared between the two groups.Results The total effective rate of the observation group was 92.50%(37/40),which was higher than 75.00%(30/40)of the control group(P<0.05);after treatment,the color,vascular distribution,softness,thickness score and VSS total score of the observation group were lower than those of the control group(P<0.05);after treatment,the water content of stratum corneum in the observation group was higher than that in the control group,TNF-α,PGRN,TGF-β1,water loss and pH value of the control group were lower than those of the control group(P<0.05);the incidence of adverse reactions in the observation group was 12.50%(5/40)and 7.50%(3/40)in the control group,with no signifificant difference(P>0.05).Conclusion Compound betamethasone combined with UFCL is effective in the treatment of HS after burn,which can inhibit the proliferation of fifibrous tissue,reduce the degree of scar,improve the skin barrier function,and has high safety.