激光联合肉毒毒素对急性阑尾炎术后瘢痕形成的影响  

Effect of Laser Combined with Botulinum Toxin Type A for the Treatment of Scar Hyperplasia after Acute Appendectomy

作　　者：季一发 周雅静 刘毅 JI Yi-fa;ZHOU Ya-jing;LIU yi(Department of Traditional Chinese Medicine,Beijing Youanmen Hospital,Capital Medical University,Beijing(100069),China)

机构地区：[1]北京市右安门医院,北京100071 [2]河南省人民医院,郑州450003

出　　处：《中国中西医结合外科杂志》2022年第3期314-316,共3页Chinese Journal of Surgery of Integrated Traditional and Western Medicine

摘　　要：目的:探讨595 nm脉冲染料激光联合肉毒毒素对急性阑尾炎术后瘢痕形成的影响。方法:选取2020年5月—12月于本院行传统急性阑尾炎手术的100例患者,采用简单随机化随机分为两组,分别为肉毒毒素组、染料激光+肉毒毒素组,每组50例。两组均行常规缝合后,肉毒毒素组采用肉毒毒素治疗,染料激光+肉毒毒素组在肉毒毒素组治疗的基础上增加595 nm脉冲染料激光治疗。分别于术后1 d、1周、1个月及3个月进行随访,采用温哥华瘢痕量表对术后瘢痕的色泽、柔软度、厚度和血管分布进行评分,并于术后3个月,对两组术后满意度和不良反应发生情况进行调查。结果:染料激光+肉毒毒素组患者术后1周、1月和3月的瘢痕色泽、柔软度、厚度及血管分布得分均低于肉毒毒素组,差异有统计学意义(P<0.05)。染料激光+肉毒毒素组患者术后满意度高于肉毒毒素组(96.0%vs 80.0%),不良反应发生率低于肉毒毒素组(6.0%vs 12.0%),差异有统计学意义(P<0.05)。结论:595 nm脉冲染料激光联合肉毒毒素治疗对术后瘢痕的改善效果比单纯肉毒毒素治疗更好。Objective To explore whether the use of 595 nm pulsed dye laser combined with botulinum toxin type A could reduce the wound scar hyperplasia after actue appendectomy.Methods 100 patients who underwent appendectomy in our hospital from May 2020 to December 2020 were randomly divided into botulinum toxin group and pulsed dye laser+botulinum toxin group.The botulinum toxin group was combined with the use of botulinum toxin A during routine suture.The pulsed dye laser+botulinum toxin group was combined with the use of pulsed dye laser and botulinum toxin during routine suture.The follow-ups were performed at 1 day,1 week,1 month and 3 months after operation.Vancouver Scar Scale was used to evaluate scar color,softness,blood vessel distribution and thickness,which were used to determine the hyperplasia of the scar.The postoperative satisfaction survey and adverse reaction were recorded.Results In the dye laser+botulinum toxin group,the scores of scar color,softness,thickness and vascular distribution were all lower at 1 week,1 month and 3 months after surgery.Compared with the botulinum toxin group,the scores of scar color,softness,thickness and vascular distribution were lower in the dye laser+botulinum toxin group 1 month after operation.Three months after operation,the scores of scar color,softness and thickness were all low.Postoperative satisfaction of patients in dye laser+botulinum toxin group and botulinum toxin group was higher than that in the control group,and the incidence of adverse reactions was lower than that in the control group,which all differences were statistically significant(all P<0.05).Conclusion The 595 nm pulsed dye laser combined with botulinum toxin has relatively more effective effect on postoperative scar improvement.

关 键 词：脉冲染料激光 肉毒毒素 瘢痕 急性阑尾炎切除术 

分 类 号：R454.2[医药卫生—治疗学]