CO_(2)点阵激光与曲安奈德联合治疗瘢痕疙瘩的效果观察

Therapeutic effect of CO_(2)fractional laser with topical triamcinolone and intrakeloid injection of triamcinolone on keloid

目的探讨CO_(2)点阵激光与曲安奈德联合治疗瘢痕疙瘩的效果。方法2019年1月至2021年12月,北京美天医疗美容医院瘢痕疙瘩患者24例,年龄22~53岁,随机分为2组:治疗1组12例,用CO_(2)点阵激光+局部外用曲安奈德治疗;治疗2组12例,用瘢痕疙瘩内曲安奈德注射治疗。每4周治疗1次,治疗4~9次,随访12个月。每次治疗前后评估瘢痕体积,并用温哥华瘢痕量表评估瘢痕情况。结果治疗后,治疗2组的瘢痕体积变化大于治疗1组(85.4%比60.1%,χ^(2)=6.19,P=0.011),治疗1组温哥华瘢痕量表评分从(7.8±1.5)分降至(4.4±1.3)分(t=4.58,P<0.05),治疗2组从(8.6±0.9)分降至(4.8±1.3)分(t=3.45,P<0.05)。治疗过程中及治疗结束时,治疗1组疼痛分数低于治疗2组,患者舒适度和依从性提高。结论CO_(2)点阵激光联合外用曲安奈德更适用于疼痛敏感的瘢痕疙瘩患者。

Objective To explore the therapeutic effect of CO_(2) fractional laser with topical triamcinolone and intrakeloid injection of triamcinolone.Methods From January 2019 to December 2021,24 cases of keloid patients in the outpatient clinic of the Department of Plastic Surgery and Aesthetics Hospital,all female,aged 22-53 years,were randomly divided into treatment group 1(12 cases),treated with CO_(2) fractional laser+local topical triamcinolone,and treatment group 2(12 cases),treated with intra-local triamcinolone injection.The treatment was done every 4 weeks for 4-9 times and followed up for 1 year.Keloid size was assessed before and after each treatment and scarring was evaluated with the Vancouver Keloid Scale.Results After treatment,the change in keloid size was greater in the treatment group 2 than that in the treatment group 1(85.4%and 60.1%,χ^(2)=6.19,P<0.05),and the Vancouver Keloid Scale score showed that it was significantly lower in the treatment group 1(7.8±1.5 versus 4.4±1.3,t=4.58,P<0.05)compared with the treatment group 2(8.6±0.9 versus 4.5±1.3,t=3.45,P<0.05).During and at the end of treatment,the pain scores of the treatment group 1 were significantly lower than those of the treatment group 2,and patients′comfort and compliance were significantly improved.Conclusions Fractional laser combined with topical triamcinolone is a more suitable treatment option for patients with pain-sensitive keloids.