点阵CO_(2)激光联合曲安奈德治疗烧伤后增生性瘢痕的疗效及对血清瘢痕增生相关因子水平的影响

Effect of Fractional Carbon Dioxide Laser Combined with Triamcinolone Acetonide on Hypertrophic Scar in Burn Patients and Its Influence on Serum Levels of Scar Hyperplasia-related Factors

目的:探讨烧伤后增生性瘢痕(Hypertrophic scar,HS)在曲安奈德基础上予以点阵二氧化碳激光治疗的效果,并探讨可能的机制。方法:使用随机数表法,将2021年1月-2023年4月青岛市市立医院收治的204例烧伤后HS患者分为对照组102例与观察组102例,分别予以曲安奈德注射、点阵CO_(2)激光联合曲安奈德注射,两组均治疗6个月。评价两组治疗效果,比较两组温哥华瘢痕量表(Vancouver scar scale,VSS)评分、疼痛评分及血清瘢痕增生相关因子[表皮生长因子(Epidermal growth factor,EGF)、转化因子-β1(Transforming factor-β1,TGF-β1)、血管内皮生长因子(Vascular endothelial growth factor,VEGF)]和炎症因子水平,并对不良反应予以统计。结果:在总有效率上,观察组较对照组更高(P<0.05)。相较于对照组,治疗后,观察组VSS评分[(4.69±0.91)分vs.(7.64±1.35)分]和疼痛评分[(3.76±0.71)分vs.(4.54±0.87)分]更低(P<0.05);观察组血清EGF、TGF-β1、VEGF和白细胞介素-6(Interleukin-6,IL-6)、肿瘤坏死因子-α(Tumor necrosis factor-α,TNF-α)水平更低(P<0.05)。两组不良反应发生率差异无统计学意义(P>0.05)。结论:烧伤后HS患者使用点阵CO_(2)激光联合曲安奈德治疗疗效显著,能够调节瘢痕生长因子和抑制炎症,改善瘢痕性状和疼痛。

Objective To investigate the effect of fractional carbon dioxide laser in combination with triamcinolone acetonide on the treatment of hypertrophic scar(HS)after burn and to explore the possible mechanism.Methods A total of 204 patients with HS after burn admitted to Qingdao Municipal Hospital from January 2021 to April 2023 were divided into a control group(n=102)and an observation group(n=102)using the random number table method.The control group was treated with triamcinolone acetonide injection,while the observation group received a combination of fractional carbon dioxide laser and triamcinolone acetonide injection.Both groups were treated for 6 months.The therapeutic effects of the two groups were evaluated.The Vancouver Scar Scale(VSS)score,pain score,serum levels of scar hyperplasia-related factors[epidermal growth factor(EGF),transforming growth factor-β1(TGF-β1),vascular endothelial growth factor(VEGF)],and inflammatory levels were compared between the two groups,and adverse reactions were recorded.Results The observation group had a higher total effective rate compared with the control group(P<0.05).After treatment,the VSS score[(4.69±0.91)points vs.(7.64±1.35)points]and pain score[(3.76±0.71)points vs.(4.54±0.87)points]in the observation group were lower than those in the control group(P<0.05).The levels of serum EGF,TGF-β1,VEGF,interleukin-6(IL-6),and tumor necrosis factor-α(TNF-α)in the observation group were also lower(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion Fractional carbon dioxide laser combined with triamcinolone acetonide is effective in the treatment of HS after burn,which can regulate scar growth factors,inhibit inflammation,and improve scar characteristics and pain.