脉冲染料激光动态治疗面部美容缝合术后早期瘢痕临床疗效  

Clinical effects of pulsed dye laser in dynamic treatment of fresh trauma scars after facial cosmetic suture

作　　者：刘振楠 李亚玲 张婷[1] 许晓晴 周粤闽 LIU Zhen-nan;LI Ya-ling;ZHANG Ting;XU Xiao-qing;ZHOU Yue-min(Department of Plastic and Reconstructive Surgery,Huaihe Hospital of Henan University,Henan Province,475000,China)

机构地区：[1]河南大学淮河医院,河南开封475000

出　　处：《中国医疗美容》2023年第10期22-26,共5页China Medical Cosmetology

摘　　要：目的 探讨脉冲染料激光的不同切入时间在动态治疗早期面部外伤瘢痕中的有效性。方法 回顾性病例系列研究分析2021年1月—2023年1月,河南大学淮河医院整形修复外科收治103例美容缝合后激光治疗患者。根据脉冲染料激光介入时间不同,将患者分为4组:A组为拆线后1周内开始脉冲染料激光治疗;B组为拆线后1-4周开始治疗;C组为拆线后1-2月开始治疗;D组为拆线后2-3月开始治疗。首次治疗前及末次治疗后1个月(以下简称治疗前与治疗后),采用温哥华瘢痕评估量表(Vancouver Scar Scale,VSS)评估瘢痕情况。治疗后,评估患者满意度及脉冲染料激光累计治疗次数。记录不良反应发生情况并计算不良反应发生率。对数据行Wilcoxon秩和检验、Kruskal-Wallis检验、2检验等。结果 末次治疗后1月,4组VSS评分组内比较均较治疗前显著降低(P <0.001)。A组治疗前、后VSS评分均低于B组(P>0.05),A、B组较C、D组治疗前瘢痕严重程度均较轻(P <0.05),C、D组瘢痕治疗后较A、B组瘢痕明显(P <0.05)。治疗后,VSS中血管分布和色泽总分A、B组低于C、D两组(P<0.05)。A、B组达到显效时的PDL治疗次数低于C、D组(P<0.05)。治疗后,A、B组满意度优于C、D组(P <0.05)。总不良反应发生率A、B、C、D组依次增加,差异无统计学意义(P>0.05)。结论 面部外伤拆线后1月内进行PDL动态治疗早期外伤瘢痕,临床疗效及满意度均高于拆线后1-3月内开始激光治疗。Objective To investigate the clinical effffects of difffferent intervention time of pulsed dye laser in dynamic treatment of fresh trauma scars.Methods A retrospectively observational study was conducted.From January 2021 to January 2023,103 patients who met the inclusion criteria were admitted to the Huaihe Hospital of Henan University.The patients were divided into four groups according to the difffferent time of PDL intervention,Traumatic scars were fifirst treated by 595 nm pulsed dye laser within 1 week after suture removal(group A),1-4 weeks after suture removal(group B),1-2 months after suture removal(group C),2-3 months after fisuture removal(group D).Before the first treatment and 1 month after the last treatment(hereinafter referred to as after treatment),the scar was evaluated by VSS scale.After treatment,the patient satisfaction and the cumulative treatment times of pulsed dye laser were evaluated.The occurrence of adverse reactions was recorded and the incidence of adverse reactions was calculated.Data were statistically analyzed with Wilcoxon rank sum test,Kruskal-Wallis test,chi-square test,etc.Results The total VSS scores in four groups fiand dynamic treatment group 1 months after treatment were significantly lower than those before treatment(P<0.05).The VSS score before and after treatment in group A was lower than that in group B(P>0.05).The severity of scar in group A and B was slighter than that in group C and D before treatment(P<0.05).The scar in group C and D was more obvious than that in group A and B after treatment(P<0.05).After treatment,the total scores of pigmentation and vascularity in VSS in group A and B were lower than those in group C and D.The cumulative times of PDL in group A and B was lower than that in group C and D(P<0.05).After treatment,the satisfaction of group A and B was better than that of group C and D(P<0.05).The total incidence of adverse reactions in groups A,B,C fffiand D increased in turn,and the difference was not statistically significant(P>0.05).Conclusion ff

关 键 词：脉冲染料激光 瘢痕 外伤 美容缝合 

分 类 号：R622[医药卫生—整形外科]