多类型激光与曲安奈德联合治疗唇裂术后瘢痕增生的疗效观察  

Observation on the efficacy of multiple types of laser and triamcinolone acetonide in the treatment of postoperative scar hyperplasia of cleft lip

作　　者：郝丽娜 郝丽莎 高静 沙晓伟[4] 代玉柱 HAO Li-na;HAO Li-sha;GAO Jing;SHA Xiao-wei;DAI Yu-zhu(Chengdu Qingyang Phil Medical Beauty Clinic,Sichuan Province,610000,China;Affiliated Hospital of Southwest Medical University,Sichuan Province,646000,China;Angel Children's Hospital in Chengdu,Sichuan Province,610000,China;Department of Dermatology,Sichuan Provincial people's Hospital,Sichuan Province,610000,China)

机构地区：[1]成都青羊菲尔医疗美容诊所,四川成都610000 [2]西南医科大学附属医院,四川泸州646000 [3]四川省成都市天使儿童医院,四川成都610000 [4]四川省人民医院皮肤科,四川成都610000

出　　处：《中国医疗美容》2022年第4期20-24,共5页China Medical Cosmetology

摘　　要：目的观察多类型激光与曲安奈德序贯多联治疗唇裂术后瘢痕增生的临床疗效。方法收集2017年6月-2019年3月期间,唇裂术后瘢痕增生(单侧唇裂:左侧22例,右侧13例;双侧唇裂2例)的患者37例,均采用双波长脉冲激光(585nm脉冲染料激光和1064nm Nd:YAG激光)和10600nm超脉冲CO_(2)点阵激光联合曲安奈德序贯多联治疗。根据温哥华瘢痕量表(Vancouver scar scale,VSS)进行评分比较,并观察治疗效果。结果随访6~12个月,治疗有效率达91.8%,其中显效11例(占29.7%),有效23例(占62.1%),无效3例(占8.1%)。治疗期间,4例患者起水疱,3例患者出现色素沉着,全部患者均伴不同程度紫癜反应,一般在7~15d自行消退。治疗后6月VSS评分结果(2.08±0.795)明显低于治疗前(12.65±1.670),差异有统计学意义(t=41.330,P<0.01)。结论多类型激光与曲安奈德序贯多联治疗唇裂术后瘢痕增生,临床疗效明显,并发症发生率低,值得临床推广。Objective To observe the clinical efficacy of sequential combination of multi-type laser and triamcinolone acetonide in the treatment of postoperative scar hyperplasia of cleft lip.Methods From June 2017 to March 2019,37 patients with postoperative scar hyperplasia of cleft lip(22 cases of unilateral left cleft lip,13 cases of unilateral right cleft lip and 2 cases of bilateral cleft lip)were collected.All patients were treated with dual-wavelength pulsed laser(585nm pulsed dye laser and 1064nmNd:YAG laser)and 10600nm ultra-pulsed CO_(2)lattice laser combined with triamcinolone acetonide sequential multiplex therapy.The scores were compared according to the Vancouver scar scale,and the therapeutic effect was observed.Results During the follow-up of 6 to 12 months,the effective rate after treatment was 91.8%,of which 11 cases were significantly effective(29.7%),23 cases were effective(62.1%),and 3 cases were ineffective(8.1%).During the treatment,4 patients developed blisters and 3 patients developed pigmentation.All patients had different degrees of purpura reaction,which generally disappeared in 7 to 15 days.Six months after treatment,the VSS score(2.08±0.795)was significantly lower than that before treatment(12.65±1.670).The difference was statistically significant(t=41.330,P<0.01).Conclusion The sequential combination of multiple types of laser and triamcinolone acetonide in the treatment of postoperative scar hyperplasia of cleft lip has obvious clinical effect and low incidence of complications.The method is worthy of clinical promotion.

关 键 词：唇裂 增生性瘢痕 双波长激光 曲安奈德 点阵激光 

分 类 号：R782.2[医药卫生—口腔医学]