复方倍他米松联合CO_(2)点阵激光、PDL激光治疗瘢痕疙瘩疗效分析  

Efficacy of Compound Betamethasone combined with CO_(2) lattice laser and PDL in treatment of keloid

作　　者：李妍 胥学冰[1] 康贺军 唐亦复 史昌乾 LI Yan;XU Xuebing;KANG Hejun;TANG Yifu;SHI Changqian(Department of Burns,Liaoning Provincial Corps Hospitalof Chinese People’s Armed Police Force,Shenyang 110034,China;Department of Psychology,Liaoning Provincial Corps Hospitalof Chinese People’s Armed Police Force,Shenyang 110034,China;Pharmacy,Liaoning Provincial Corps Hospitalof Chinese People’s Armed Police Force,Shenyang 110034,China)

机构地区：[1]武警辽宁总队医院烧伤科,沈阳110034 [3]武警辽宁总队医院心理科,沈阳110034 [2]武警辽宁总队医院药局,沈阳110034

出　　处：《武警医学》2022年第7期618-622,共5页Medical Journal of the Chinese People's Armed Police Force

摘　　要：目的观察分析复方倍他米松(商品名得宝松)联合CO_(2)点阵激光、PDL激光治疗瘢痕疙瘩的临床疗效。方法选取2018-04至2019-12武警辽宁总队医院接受治疗的111例瘢痕疙瘩患者作为研究对象,随机分为A组、B组、C组,每组37例。A组采用CO_(2)点阵激光+PDL激光治疗,B组采用CO_(2)点阵激光+得宝松治疗,C组采用得宝松联合CO_(2)点阵激光+PDL激光治疗,每4周为1疗程,共3个疗程。所有患者在治疗6个月后进行观察,观察3组治疗前后瘢痕各维度评分(VSS)、转化生长因子β_(1)(TGF-β_(1))、基质金属蛋白酶9(MMP-9)含量变化,以及临床疗效、不良反应及复发率情况。结果治疗6个月后,三组色泽、血管分布、瘢痕柔软度、厚度、VSS总分较治疗前显著降低,其中C组显著优于A组、B组(P<0.05),但B组和C组未见统计学差异;A组、B组、C组总有效率分别为86.49%、83.78%、94.60%,C组疗效显著优于A组和B组(P<0.05);治疗1个月后,三组TGF-β_(1)、MMP-9表达含量较治疗前显著改善(P<0.05),C组TGF-β_(1)、MMP-9表达显著低于A组和B组(P<0.05),而A组和B组比较,未见统计学差异;在治疗后1个月时,A组2例瘢痕疙瘩治疗区域出现部分色素沉着,B组3例出现颜色发红、血管丰富情况,其余患者均未出现疼痛、血肿、瘙痒、皮肤感染、色素沉着及皮肤萎缩等不良反应,且未见复发;在治疗6个月时,患者色素沉着及颜色发红等不良反应基本消退,但三组均出现部分瘢痕疙瘩复发情况,复发率分别为8.11%(3例,A组)、5.41%(2例,B组)及2.70%(1例,C组)(χ^(2)=0.24,P=0.98)。结论得宝松联合CO_(2)点阵激光、PDL治疗瘢痕疙瘩疗效确切,安全性高,有效促进瘢痕组织恢复,值得临床推广。Objective To observe and analyze the clinical efficacy of Compound Betamethasone(Debaosong)combined with CO_(2)lattice laser and PDL laser in the treatment of keloid.Methods A total of 111 patients with keloid treated in our department from April 2018 to December 2019 were randomly divided into group A,group B and group C,with 37 patients in each group.Group A was treated with CO_(2)dot array laser+PDL laser,group B was treated with CO_(2)dot array laser+Debaosong,and group C was treated with Debaosong combined with CO_(2)dot array laser+PDL laser every 4 weeks(a course of treatment)for 3 courses.All patients were observed within six months of treatment,and the changes of scar score(VSS),transforming growth factorβ_(1)(TGF-β_(1)),matrix metalloproteinase-9(MMP-9)expression levels,clinical efficacy,adverse reactions and recurrence rate were observed before and after treatment in the three groups.Results After 6 months of treatment,the color,vascular distribution,scar softness,thickness and VSS scores of the three groups significantly decreased,and group C was significantly better than group A and B(P<0.05),but there was no statistical difference between group B and group C(P>0.05).The total effective rate of group A,B and C was 86.49%,83.78%and 94.60%,respectively.The curative effect of group C was significantly better than that of group A and B(P<0.05).After 1 month of treatment,the expression levels of TGF-β_(1)and MMP-9 in the three groups were significantly improved(P<0.05).The expression levels of TGF-β_(1)and MMP-9 in group C were significantly lower than those in groups A and B(P<0.05),while there was no statistical difference between group A and B.At the end of the first month after treatment,2 patients in Group A showed partial pigmentation in the treated area of keloid,and 3 patients in Group B showed redness and abundant blood vessels.No pain,hematoma,pruritus,skin infection,pigmentation and skin atrophy or other adverse reactions were found in the other patients,and no recurrence was observed.At th

关 键 词：瘢痕疙瘩 CO_(2)点阵激光 PDL激光 临床疗效 复发率 

分 类 号：R622[医药卫生—整形外科]