二氧化碳点阵激光联合壳聚糖季铵盐硅凝胶治疗烧伤后增生性瘢痕临床研究  

Clinical study of carbon dioxide fractional laser combined with chitosan quaternary ammonium salt silica gel in the treatment of hypertrophic scar after burn

作　　者：张强强 张文博 武海龙 ZHANG Qiang-qiang;ZHANG Wen-bo;WU Hai-long(Burn Plastic Surgery,Luoyang Central Hospital Affiliated to Zhengzhou University,Henan Province,471000,China;Departmentof Plastic Surgery,Xuchang Central Hospital,Henan Province,461000,China)

机构地区：[1]郑州大学附属洛阳中心医院烧伤整形外科,河南洛阳471000 [2]许昌市中心医院整形科,河南许昌461000

出　　处：《中国医疗美容》2021年第9期67-70,共4页China Medical Cosmetology

摘　　要：目的探究二氧化碳点阵激光联合壳聚糖季铵盐硅凝胶治疗烧伤后增生性瘢痕应用效果。方法选取2019年3月~2021年1月本院收治的烧伤后增生性瘢痕患者93例,按随机数字表法将患者分为联合组46例和对照组47例,对照组采用壳聚糖季铵盐硅凝胶进行治疗,实验组在对照组基础上联合二氧化碳点阵激光进行治疗,观察两组临床疗效,比较治疗前后患者疼痛视觉模拟(Visual Analogue Scale,VAS)评分、温哥华瘢痕量表(Vancouver Scar Scale,VSS)评分、患者和观测者瘢痕评价量表(Patient and Observer Scar Assessment Scale,POSAS)评分变化。结果联合组临床总有效率为97.83%,明显高于对照组的85.11%(P<0.05);治疗1周、2周、1个月后,联合组VAS评分明显低于对照组(P<0.05);治疗3个月后,联合组VSS量表中色泽、厚度、柔软度、血管分布评分均明显低于对照组(P<0.05);治疗3个月后,联合组POSAS量表中患者评分、观测者评分均明显低于对照组(P<0.05)。结论二氧化碳点阵激光联合壳聚糖季铵盐硅凝胶治疗烧伤后增生性瘢痕疗效显著,可缓解患者创面疼痛程度,抑制瘢痕形成,提高患者创面美观度,具有较高临床应用价值。Objective To explore the application effect of carbon dioxide fractional laser combined with chitosan quaternary ammonium salt silica gel in the treatment of hypertrophic scar after burn.Methods A total of 93 patients with hypertrophic scar after burn were selected between March 2019 and January 2021.They were divided into combined group(46 cases)and control group(47 cases)according to random number table method.Patients in the control group were treated with chitosan quaternary ammonium salt silica gel,while patients in the experimental group were treated with carbon dioxide fractional laser combined with chitosan quaternary ammonium salt silica gel.Clinical effects of the two groups were observed.Changes in the visual analogue scale(VAS)scores,the Vancouver Scar Scale(VSS)scores,and the Patient and Observer Scar Assessment Scale(POSAS)scores before and after treatment were compared between the two groups.Results The total clinical response rate in the combined group was 97.83%,significantly higher than 85.11%in the control group(P<0.05).After 1 week,2 weeks and 1 month of treatment,the VAS scores of combined group were significantly lower than those of the control group(P<0.05).After 3 months of treatment,the color,thickness,softness,and blood vessel distribution scores in the VSS scale of the combined group were significantly lower than those of the control group(P<0.05).Meanwhile,the patient and observer scores in the POSAS scale of the combined group were significantly lower than those of the control group(P<0.05).Conclusion Carbon dioxide fractional laser combined with chitosan quaternary ammonium salt silica gel is effective in the treatment of hypertrophic scar after burn.It can relieve wound pain,inhibit scar formation,and improve the aesthetics of wounds.

关 键 词：烧伤 增生性瘢痕 二氧化碳点阵激光 壳聚糖季铵盐硅凝胶 临床效果 

分 类 号：R644[医药卫生—外科学]