烧伤创疡再生医疗技术在瘢痕内切除薄化及CO_2点阵激光治疗增生性瘢痕中的应用研究  

Study on the Application of MEBT/MEBO in the Treatment of Hypertrophic Scar with Intralesional Excision & Thinning and CO_2 Fractional Laser

作　　者：殷东京[1] 孙记燕[1] 赵贤忠[1] 葛永亮[1] 方进勇[2] Yin Dongjing;Sun Jiyan;Zhao Xianzhong;Ge Yongliang;Fang Jinyong(Burn and Plastic Surgery Department,Nantong Third People＇ s Hospital,Nantong City,Jiangsu 226006,Chin;Beijing Rongxiang Institute of Regenerative Medicine,Beijing 100020,China)

机构地区：[1]南通市第三人民医院烧伤整形外科,江苏南通226006 [2]北京荣祥再生医学研究所,北京100020

出　　处：《中国烧伤创疡杂志》2018年第4期290-295,共6页The Chinese Journal of Burns Wounds & Surface Ulcers

摘　　要：目的对比观察烧伤创疡再生医疗技术在瘢痕内切除薄化及CO_2点阵激光治疗增生性瘢痕中的应用效果,探讨增生性瘢痕的治疗新理念。方法选择2006年1月—2016年12月南通市第三人民医院收治的60例增生性瘢痕患者作为研究对象,每例患者选择2处相似的增生性瘢痕随机分为试验组与对照组,其中试验组于瘢痕内切除薄化术后采用烧伤创疡再生医疗技术治疗术后创面,3个月后采用CO_2点阵激光再次治疗此处瘢痕,并于激光术后应用烧伤创疡再生医疗技术治疗术后创面;对照组于瘢痕内切除薄化术后采用凡士林油纱治疗术后创面,3个月后采用CO_2点阵激光再次治疗此处瘢痕,并于激光术后应用红霉素眼膏及医用硅酮凝胶膏序贯治疗术后创面。对比观察两组瘢痕内切除薄化术后治疗疗程结束后及CO_2点阵激光术后治疗疗程结束后的瘢痕增生情况、CO_2点阵激光术后1 h的创面疼痛程度及点阵激光术后创面完全上皮化时间。结果瘢痕内切除薄化术后治疗疗程结束后两组瘢痕VSS评分对比采用u检验,u=70.488,P<0.01,差异具有统计学意义;CO_2点阵激光术后治疗疗程结束后两组瘢痕VSS评分对比采用u检验,u=20.585,P<0.01,差异具有统计学意义;CO_2点阵激光术后1 h两组创面VAS评分对比采用u检验,u=47.829,P<0.01,差异具有统计学意义;CO_2点阵激光术后两组创面完全上皮化时间对比采用u检验,u=33.906,P<0.01,差异具有统计学意义。结论烧伤创疡再生医疗技术可有效缓解增生性瘢痕CO_2点阵激光术后创面疼痛,促进创面愈合及瘢痕内切除薄化与CO_2点阵激光术后瘢痕组织消退,疗效显著,临床应用价值较高,是目前临床上防治增生性瘢痕的理想疗法。Objective To observe the effect of applying MEBT/MEBO together with intralesional excision thinning and CO_2 fractional laser in the treatment of hypertrophic scar and explore new ideas for the treatment of hypertrophic scars. Methods Sixty patients with hypertrophic scars admitted to Nantong Third People＇s Hospital from January 2006 to December 2016 were selected as the subjects. Two similar hypertrophic scars in each patient were selected as an experimental group and a control group. Scars in the experimental group were given intralesional excision thinning,followed by the application of MEBT/MEBO; Three months later,CO_2 fractional laser was used to treat the scars and still the postoperative wounds were continued to be treated with MEBT/MEBO. In contrast,scars in the control group were treated with intralesional excision thinning,followed by the application of Vaseline gauze; Three months later,CO_2 fractional laser was used to treat the scars and the postoperative wounds were given the sequential application of erythromycin eye ointment and silicone gel. Scar hyperplasia condition after the treatment course of intralesional excision thinning and after CO_2 fractional laser operation,wound pain one hour after CO_2 fractional laser operation,and complete epithelialization timing after CO_2 fractional laser operation were observed and compared in the two groups. Results At the end of the treatment course of intralesional excision thinning,u test was adopted to compare the VSS scores between the two groups and the result showed statistically significant difference（ u = 70. 488,P〈0. 01）; u test was adopted to compare the VSS scores between the two groups at the end of the treatment course of CO_2 fractional laser operation and the result showed statistically significant difference（ u = 20. 585,P〈0. 01）; the VAS scores one hour after CO_2 fractional laser operation in the two groups were compared with u test,which showed statistically significant difference（ u = 47. 829,P〈0. 01）; the complete e

关 键 词：增生性瘢痕 烧伤创疡再生医疗技术 瘢痕内切除薄化 CO2点阵激光 湿润烧伤膏 疤痕软膏 硅酮凝胶 

分 类 号：R644[医药卫生—外科学]