CO2点阵激光对预防内眦赘皮矫正术后瘢痕增生的疗效分析

Analysis of the efficacy of CO2 fractional laser on the prevention of scar hyperplasia after epicanthoplasty

目的探讨CO2点阵激光对预防内眦赘皮矫正术后切口瘢痕增生的有效性。方法采用回顾性分析的方法,将162例接受内眦赘皮矫正术的患者,按照术后接受干预方法的不同分为治疗组(84例)和对照组(78例)。治疗组于拆线时(术后5~7 d),术后1、2个月分别应用CO2点阵激光对切口进行治疗,共治疗3次;对照组未行CO2点阵激光处理,仅进行常规护理。于拆线日(激光治疗前)及术后6个月应用改良曼彻斯特瘢痕量表(modified manchester scar scale,MMSS)对治疗组和对照组的瘢痕情况进行定量分析。结果治疗组及对照组均无明显术后并发症发生。拆线时(激光治疗前),两组MMSS总分差异无统计学意义(P>0.05);术后6个月(末次激光治疗后4个月),两组MMSS总分相对于治疗前均减少(P<0.05);治疗组MMSS总分相对于对照组明显减少(P<0.05);治疗组MMSS各子项目(VAS、瘢痕颜色、平整度和外形)评分均较对照组减少(P<0.05)。结论内眦赘皮矫正术后早期给予CO2点阵激光进行干预,可以有效预防内眦赘皮矫正术后切口的瘢痕增生。

Objective To explore the efficacy and safety of CO2 fractional laser on the prevention of scar hyperplasia after epicanthoplasty.Methods One hundred and sixty-two patients who underwent epicanthoplasty were retrospectively analyzed and divided into a treatment group(84 patients)and a control group(78 patients),according to the different postoperative intervention methods used.For the treatment group,the incision was treated by CO2 fractional laser a total of three times:at the time of suture removal(5 to 7 days after operation),and 1,2 months after epicanthoplasty.Only routine nursing was given for the control group.The scar status of both groups was quantitatively analyzed by the modified Manchester scar scale(MMSS)on the day of suture removal(before the first CO2 fractional laser treatment)and 6 months after epicanthoplasty.Results No obvious postoperative complications occurred in either group.There was no statistical difference in the total score ofMMSS between the two groups on the day of suture removal(before laser treatment)(P>0.05).The total score of MMSS at 6 months(4 months after last laser treatment)after epicanthoplasty of both groups were lower than that before treatment(P<0.05).The total score of MMSS of the treatment group was significantly lower than that of the control group(P<0.05).The score of subitems of MMSS such as VAS,color,smoothness,and shape in the treatment group was less than that in the control group(P<0.05).Conclusion Early intervention by CO2 fractional laser after epicanthoplasty can effectively prevent scar hyperplasia in the incision.