超脉冲点阵CO_(2)激光联合湿润烧伤膏外用在面颈部烧伤后瘢痕修复中的应用  

Application of Ultra-pulsed Fractional CO_(2) Laser Combined with MEBO External Use in the Repair of Scar after Faciocervical Burns

作　　者：彭英[1] 张逸[1] 王磊[1] PENG Ying;ZHANG Yi;WANG Lei(Department of Burn and Plastic Surgery,Affi liated Hospital of Nantong University,Nantong 226001,Jiangsu,China)

机构地区：[1]南通大学附属医院烧伤整形科,江苏南通226001

出　　处：《中国美容医学》2022年第7期31-35,共5页Chinese Journal of Aesthetic Medicine

基　　金：2020年度南通市市级科技计划(指导性)项目(编号:MSZ20121);2020年度市级临床医学中心项目(编号:HS2020006)。

摘　　要：目的:探讨超脉冲点阵CO_(2)激光联合湿润烧伤膏(Moist exposed burn ointment,MEBO)外用在面颈部烧伤后瘢痕修复中的应用效果。方法:选取2019年1月-2021年1月在笔者医院确诊的82例面颈部烧伤后瘢痕患者为研究对象,采用简单随机分组将患者分为观察组和对照组,每组41例。对照组超脉冲点阵CO_(2)激光治疗后应用红霉素眼膏涂抹,观察组激光治疗后应用MEBO。观察并记录疼痛时间、脱痂时间和创面愈合时间;采用温哥华瘢痕量表(Vancouver scar scale,VSS)评估治疗前和治疗3个月后瘢痕情况;采用视觉模拟评分法(Visual analogue scale,VAS)评估激光治疗后1 h和24 h的疼痛程度;使用皮肤病生活质量指数量表(Dermatology life quality index,DLQI)评估患者生活质量;免疫组化法检测角蛋白19(CK19)和核蛋白p63阳性表达;记录两组患者治疗期间不良反应发生情况。结果:观察组治疗总有效率为95.12%,高于对照组的80.49%,差异有统计学意义(P<0.05)。观察组疼痛时间、脱痂时间、创面愈合时间、VSS评分、VAS评分和DLQI评分均明显低于对照组,差异有统计学意义(P<0.05)。治疗3 d后,观察组CK19和p63强阳性率高于对照组,但组间比较差异无统计学意义(P>0.05);治疗7 d后,观察组CK19和p63强阳性率显著高于对照组,差异有统计学意义(P<0.05)。治疗3个月后,观察组不良反应发生率为17.07%,低于对照组的31.71%,但组间比较差异无统计学意义(P>0.05)。结论:超脉冲点阵CO_(2)激光联合MEBO外用治疗面颈部烧伤后瘢痕美学效果显著,能够加速创面愈合。Objective To explore the application of ultra-pulsed fractional CO_(2) laser combined with MEBO external use in the repair of scar after faciocervical burns.Methods A total of 82 patients with scars after faciocervical burns confirmed in the hospital were enrolled between January 2019 and January 2021.According to simple random grouping method,they were divided into the observation group and the control group,41 cases in each group.In the control group,erythromycin eye ointment was applied after ultra-pulsed fractional CO_(2) laser treatment,while the observation group was treated with MEBO after ultra-pulsed fractional CO_(2) laser treatment.The pain time,decrustation time and wound healing time were observed and recorded.The scar conditions before treatment and after 3 months of treatment were assessed by VSS.The pain level was evaluated by VAS at 1 h and 24 h after laser treatment.The quality of life was evaluated by DLQI.The positive expressions of CK19 and p63 were detected by immunohistochemistry.The occurrence of adverse reactions during treatment in both groups was recorded.Results The response rate of treatment in the observation group was higher than that in the control group (95.12% vs 80.49%),the difference was statistically significant (P<0.05).After treatment,the pain time,decrustation time,wound healing time,VSS score,VAS score and DLQI score in the observation group were significantly lower than those in the control group (P<0.05).After 3 d of treatment,strong positive rates of CK19 and p63 in the observation group were higher than those in control group,but there were no significant difference between the two groups (P>0.05).After 7 d of treatment,strong positive rates of CK19 and p63 in the observation group were significantly higher than those in the control group (P<0.05).After 3 months of treatment,incidence of adverse reactions in the observation group was lower than that in the control group (17.07% vs 31.71%),but there was no significant difference between the two groups (P>0.05).Conclusio

关 键 词：湿润烧伤膏 超脉冲点阵CO_(2)激光 瘢痕 烧伤 面颈部 美学效果 

分 类 号：R619.6[医药卫生—外科学]