强脉冲光联合点阵CO_(2)激光治疗儿童下肢烧伤后增生性瘢痕的效果评价  

Efficacy evaluation of intense pulsed light combined with lattice CO_(2) laser in the treatment of hypertrophic scar after burn of lower limb in children

作　　者：邢福席 刘继松 XING Fu-xi;LIU Ji-song(The Third People's Hospital of Bengbu,Bengbu Medical College,Anhui Province,233000,China)

机构地区：[1]蚌埠医学院附属蚌埠市第三人民医院,安徽蚌埠233000

出　　处：《中国医疗美容》2021年第4期61-65,共5页China Medical Cosmetology

摘　　要：目的观察临床上应用点阵CO_(2)激光联合强脉冲光治疗儿童下肢烧伤后增生性瘢痕的效果。方法选取2018年1月-2020年6月就诊于蚌埠市第三人民医院整形美容中心烧伤后符合标准的儿童患者36人,男18例,女18例年龄0-5岁,平均年龄为(2.3±0.2岁),增生性瘢痕的皮损面积大小为(7.8%±2.3%)。在创面愈合半年后开始进行激光治疗,强脉冲光治疗2次,治疗间隔一个月,2次强脉冲光治疗后一个月后接受2次点阵CO_(2)激光治疗,治疗间隔二个月。分别于患者治疗前、2次强脉冲光治疗后2周、2次点阵CO_(2)治疗后2周,采用温哥华瘢痕量表(vss)、视觉模拟评分法、患者和观察者瘢痕评估量表等进行疗效评估。记录治疗过程中发生的不良反应,对以上所有数据进行t检验。结果治疗前患者温哥华瘢痕量表的形态评分、视觉模拟评分法评定的瘢痕的瘙痒程度、部位等、患者和观察者瘢痕评估量表得分分布差异均无统计学意义(p>0.05)。2次强脉冲光治疗后2周温哥华瘢痕量表的形态评分、视觉模拟评分法评定的瘢痕的瘙痒程度、部位等、患者和观察者瘢痕评估量表评分较治疗前明显降低(p<0.05),其差异均具有统计学意义。2次点阵CO_(2)激光治疗后2周温哥华瘢痕量表的形态评分、视觉模拟评分法评定的瘢痕的瘙痒程度、部位等、患者和观察者瘢痕评估量表评分较强脉冲光治疗后明显降低(p<0.05),其差异均具有统计学意义。在随访的观察中,有3例患者出现红斑,经过几天后红斑消失;有4例患者出现渗血,在调整激光参数后渗血得以改善;有1例患者出现局部的感染,经过多次换药后好转。结论采用强脉冲光联合点阵CO_(2)激光治疗儿童烧伤后增生性瘢痕的疗效较好,值得临床应用。Objective To observe the clinical effect of dot array CO_(2) laser combined with intense pulsed light on hypertrophic scar after burn of lower limb in children.Methods A total of 36 pediatric patients(18 males and 18 females,aged 0-5 years old,with an average age of 2.3±0.2 years)who were admitted to the Plastic Surgery and Cosmetic Center of the Third People's Hospital of Bengbu from January 2018 to June 2020 and who met the standards after burn were selected.The size of hyperplastic scar lesions was 7.8%±2.3%.Laser treatment was started half a year after wound healing,with two times of intense pulsed light treatment at an interval of one month.One month after the two times of intense pulsed light treatment,two times of dot matrix CO_(2) laser treatment at an interval of two months was received.Before treatment,2 weeks after 2 times of intense pulsed light therapy,and 2 weeks after 2 times of dot matrix CO_(2) therapy,the efficacy was evaluated using the Vancouver Scar Scale(VSS),visual analogue score,and patient and observer scar assessment scales.Adverse reactions occurred duringtreatment were recorded,and t test was performed on all the above data.Results Before treatment,there were no significant differences in the morphological scores of the Vancouver Scar Scale,the itching degree and location of the scar assessed by visual analogue scoring method,and the distribution of the scores of the scar assessment scale between the patients and the observers(P>0.05).After 2 times of intense pulse light treatment,the morphological scores of the Vancouver Scar Scale,the itching degree and location of scar assessed by visual analogue scoring method,and the scores of the scar assessment scale of patients and observers were significantly lower than those before treatment 2 weeks after treatment(P<0.05),and the differences were statistically significant.After 2 times of dot matrix CO_(2) laser treatment,the morphological scores of Vancouver Scar Scale,the itching degree and location of scar assessed by visual analogue sc

关 键 词：烧伤 瘢痕 强脉冲光 点阵CO_(2)激光 

分 类 号：R726.2[医药卫生—儿科]