点阵CO_(2)激光联合曲安奈德和氟尿嘧啶治疗病理性瘢痕疗效观察  

Efficacy of Fractional CO_(2)Laser Combined with triamcinolone acetonide and Fluorouracil Mixed Injection in Pathological Scar Treatment

作　　者：汤云阳 林小飞 王嘉欣[1] 王连英[1] TANG Yunyang;LIN Xiaofei;WANG Jiaxin;WANG Lianying(Department of Plastic Surgery,Qinhuangdao First Hospital,Qinhuangdao 066000,Hebei,China)

机构地区：[1]秦皇岛市第一医院烧伤整形美容外科,河北秦皇岛066000

出　　处：《中国美容医学》2023年第5期112-116,共5页Chinese Journal of Aesthetic Medicine

基　　金：秦皇岛市科技局项目(编号:201902A070)。

摘　　要：目的:探讨点阵CO_(2)激光联合曲安奈德和氟尿嘧啶混合液注射治疗病理性瘢痕的临床疗效及安全性。方法:将2018年9月-2020年9月笔者医院收治的30例病理性瘢痕患者以随机数字表法分为3组,每组各10例。对照1组行瘢痕内注射曲安奈德和氟尿嘧啶混合液治疗;对照2组行点阵CO_(2)激光治疗;观察组行点阵CO_(2)激光联合瘢痕内注射曲安奈德和氟尿嘧啶混合液治疗。对比分析三组治疗1个月、2个月及3个月后瘢痕评分(Vancouver scar scale,VSS)、痛痒觉评分(Visual analogue scale,VAS),治疗前后转化生长因子-β_(1)(Transforming growth factor-β_(1),TGF-β_(1))水平及复发率。结果:三组患者均完成了治疗疗程。随着时间的增加三组VAS评分均逐步降低。治疗3个月时观察组VAS评分显著低于对照组,差异具有统计学意义(P<0.05)。随着时间的增加三组VSS评分均逐步降低,表现为三组VSS评分治疗前>治疗1个月>治疗2个月>治疗3个月,治疗2个月及治疗后3个月观察组VSS评分均显著低于对照组,差异具有统计学意义(P<0.05)。三组治疗后血清TGF-β_(1)水平均降低,治疗后观察组血清TGF-β_(1)水平均低于对照组,差异具有统计学意义(P<0.05)。结论:采用点阵CO_(2)激光联合曲安奈德和氟尿嘧啶混合液瘢痕内注射治疗病理性瘢痕疗效更好,安全性较高,值得临床推广。Objective To investigate the clinical efficacy and safety of fractional CO_(2)laser combined with triamcinolone acetonide and fluorouracil mixture injection for pathological scar treatment.Methods Thirty patients with pathological scar admitted to the author's hospital from September 2018 to September 2020 were divided into 3 groups by random number table method,with 10 cases in each group.The control 1 group was treated with intra-scar injection of trimethoprim and fluorouracil mixture;the control 2 group was treated with fractional CO_(2)laser;the observation group was treated with fractional CO_(2)laser combined with intra-scar injection of trimethoprim and fluorouracil mixture.The three groups were compared on the basis of the Vancouver scar scale,visual analogue scale,the TGF-β_(1)levels and recurrence rate after 1 month,2 months and 3 months of treatment.levels and recurrence rates.Results All three groups of patients completed the treatment course.The VAS score gradually decreased in all three groups as the time increased.At 3 months of treatment,the VAS score of the observation group was significantly lower than that of the control groups,and the difference was statistically significant(P<0.05).The VSS scores of all three groups decreased gradually with the increase of time,which showed that the VSS scores of the three groups before treatment>1 month of treatment>2 months of treatment>3 months of treatment,and the VSS scores of the observation group were significantly lower than those of the control groups at 2 months of treatment and 3 months after treatment,and the difference was statistically significant(P<0.05).The TGF-β_(1)levels decreased in all three groups after treatment,and the TGF-β_(1)levels in the observation group were lower than those in the control groups after treatment,with statistically significant differences(P<0.05).Conclusion Fractional CO_(2)laser combined with triamcinolone acetonide and fluorouracil mixture injection for pathological scar is more effective and deserves clinical

关 键 词：病理性瘢痕 点阵CO_(2)激光 曲安奈德 氟尿嘧啶 转化生长因子-β_(1) 

分 类 号：R622[医药卫生—整形外科]