瘢痕内曲安奈德注射、超脉冲CO_(2)点阵激光及二者联合治疗老年增生性瘢痕的临床疗效对比研究  

Effect of intrascar triamcinolone acetonide injection,ultrapulse fractional carbon dioxide laser,and combination therapy for the treatment of elderly patients with hypertrophic scar

作　　者：林琳 刘维丽[2] 宣晓梅[1] 王静[3] LIN Lin;LIU Wei-li;XUAN Xiao-mei(Department of Dermatology,the First Hospital of Hebei Medical University,Shijiazhuang Hebei 050031,China.;Department of Hepatobiliary Surgery,the First Hospital of Hebei Medical University,Shijiazhuang Hebei 050031,China.)

机构地区：[1]河北医科大学第一医院皮肤科,河北石家庄050031 [2]河北医科大学第一医院肝胆外科,河北石家庄050031 [3]河北医科大学第一医院健康管理中心,河北石家庄050031

出　　处：《临床和实验医学杂志》2021年第18期2008-2011,共4页Journal of Clinical and Experimental Medicine

基　　金：2018年度河北省医学科学研究重点课题计划(编号:20180260)。

摘　　要：目的对比瘢痕内曲安奈德(TA)注射、超脉冲CO_(2)点阵激光(UPCO_(2))及两者联合治疗老年增生性瘢痕(HS)的临床疗效。方法回顾性将2017年8月至2020年3月河北医科大学第一医院皮肤科收治的114例老年HS患者纳入本研究,根据不同治疗方式分为TA组、UPCO_(2)组和联合组,其中TA组患者接受瘢痕内TA注射治疗,UPCO_(2)组患者接受UPCO_(2)治疗,联合组患者接受瘢痕内TA注射联合UPCO_(2)治疗。比较3组的临床疗效,治疗前后温哥华瘢痕量表(VSS)、视觉模拟疼痛量表(VAS)、瘙痒评分变化情况,治疗结束后6个月的不良反应发生率和复发率,以及总的治疗费用。结果联合组的临床总有效率(96.97%)比TA组(75.00%)和UPCO_(2)组(77.78%)高,差异有统计学意义(P<0.05)。治疗结束后,联合组VSS、VAS和瘙痒评分分别为(4.05±1.24)、(3.00±0.62)、(2.02±0.51)分,均低于TA组[(5.57±1.39)、(3.98±0.74)、(3.09±0.55)分]和UPCO_(2)组[(5.42±1.32)、(3.74±0.69)、(2.78±0.48)分],差异均有统计学意义(P<0.05)。联合组、TA组、UPCO 2组的不良反应发生率(6.25%vs 16.7%vs 11.1%)和复发率(3.13%vs 11.1%vs 8.89%)比较,差异均无统计学意义(P>0.05);联合组治疗总费用为(6784.3±485.2)元,均高于TA组(4352.8±432.3)元和UPCO_(2)组(5534.8±525.6)元,差异均有统计学意义(P<0.05)。结论瘢痕内TA注射联合超脉冲CO_(2)点阵激光治疗老年HS疗效良好,可显著改善临床症状,安全性好,复发率低。Objective To compare the clinical effects of intra-scar triamcinolone acetonide(TA)injection,ultra-pulse CO_(2) lattice laser(UPCO_(2))and their combination in the treatment of senile hypertrophic scar(HS).Methods A total of 114 elderly HS patients admitted to the Department of Dermatology,the First Hospital of Hebei Medical University from August 2017 to March 2020 were retrospectively included in this study,and were divided into three groups according to different treatment methods:TA group(n=36),UPCO_(2) group(n=45)and combination group(n=32).Patients in TA group were treated with intrascar injection of TA,patients in UPCO_(2) group were treated with UPCO_(2),and patients in combination group were treated with intrascar injection of TA combined with UPCO_(2).The clinical effects of the three groups were compared,the changes of Vancouver scar scale(VSS),visual analog pain scale(VAS)and pruritus score before and after treatment,the incidence and recurrence rate of adverse reactions 6 months after treatment,and the total cost of treatment were also compared.Results The total clinical effective rate of the combination group(96.97%)was much higher than that of the TA group(75.00%)and the UPCO_(2) group(77.78%),the difference was statistically significant(P<0.05).After treatment,the scores of VSS,VAS and pruritus in the combined group were(4.05±1.24),(3.00±0.62),(2.02±0.51)points,respectively,which were lower than those in the TA group[(5.57±1.39),(3.98±0.74),(3.09±0.55)points]and UPCO_(2) group[(5.42±1.32),(3.74±0.69),(2.78±0.48)points],the differences were statistically significant(P<0.05).There was no statistically significant difference in the incidence of adverse reactions(6.25%vs 16.7%vs 11.1%)and recurrence rate(3.13%vs 11.1%vs 8.89%)in the combination group,TA group,and UPCO_(2) group(P>0.05).The total treatment cost of the combined group was(6784.3±485.2)yuan,which was higher than that of the TA group(4352.8±432.3)yuan and the UPCO_(2) group(5534.8±525.6)yuan,the difference was statistically sig

关 键 词：增生性瘢痕 瘢痕内注射 超脉冲CO_(2)点阵激光 联合 

分 类 号：R622[医药卫生—整形外科]