儿童手指挛缩性瘢痕激光治疗体会  

Experience of laser treatment of finger contracture scars in children

作　　者：周念[1] 夭志刚 浦芸静 江弘婧 李丹晨 邢璐 张鸫媛 舒虹[1] ZHOU Nian;YAO Zhigang;PU Yunjing;JIANG Hongjing;LI Danchen;XING Lu;ZHANG Dongyuan;SHU Hong(Department of Dermatology;Department of Urology,Kunming Children’s Hospital,Kunming Medical University,Kunming 650034,China)

机构地区：[1]昆明医科大学附属儿童医院皮肤科,云南省昆明市650034 [2]昆明医科大学附属儿童医院泌尿外科,云南省昆明市650034

出　　处：《组织工程与重建外科》2023年第5期454-458,共5页Journal of Tissue Engineering and Reconstructive Surgery

摘　　要：目的探讨小儿手指挛缩性瘢痕激光治疗经验。方法采用自身前后对照研究方法,选取2021年12月至2022年12月,昆明市儿童医院皮肤科收治的30例手指挛缩性瘢痕患儿。其中17例瘢痕外观色红、充血明显,使用脉冲染料激光(PDL,585 nm)联合超脉冲CO_(2)点阵激光进行治疗;13例肤色瘢痕单独使用超脉冲CO_(2)点阵激光进行治疗。每例患儿治疗3次,每次治疗间隔2个月。治疗前、治疗后分别采用温哥华瘢痕评分量表(VSS)对瘢痕情况进行评分,并记录治疗前后受累关节活动度的变化以及不良反应发生情况,治疗结束8周后进行疗效评价。结果所有病例治疗后与治疗前相比,VSS评分均明显下降(P<0.05),受累关节活动度明显优于首次治疗前(P<0.05)。疗效评价结果显示,显效19例、有效8例、无效3例,显效率63.3%,有效率90.0%。治疗区域治疗后均未观察到水疱、感染、增生性瘢痕形成等不良反应。结论激光治疗小儿手指挛缩性瘢痕效果明显,相关并发症少,值得临床推广。Objective To explore the experience of laser treatment for finger contracture scars in children.Methods A retrospective before-after self-control study was conducted.Thirty patients with finger contracture scars from December 2021 to December 2022 were admitted.Among them,17 cases of scars with red appearance and obvious congestion were treated with pulsed dye laser(PDL,585 nm)combined with ultra pulse carbon dioxide lattice laser,while 13 cases of skin scars were treated with ultra pulse carbon dioxide lattice laser alone.Each patient was treated three times,with a 2-month interval between each treatment.Before and after treatment,the Vancouver Scar Scale(VSS)was used to score the scar condition,and the changes in the range of motion of the affected joint before and after treatment,as well as the occurrence of adverse reactions,were recorded.The efficacy was evaluated 8 weeks after the end of treatment.Results After treatment,the VSS score of all cases decreased significantly compared to before treatment(P<0.05),the range of motion of the affected joint was significantly higher than before the first treatment(P<0.05).The efficacy evaluation results showed that there were 19 cases of significant improvement,8 cases of effective treatment,and 3 cases of ineffective treatment,with a significant improvement rate of 63.3%and an effective rate of 90.0%.No adverse reactions such as blisters,infections,or hypertrophic scar formation were observed in the treatment area after treatment.Conclusion Laser treatment of finger contracture scar in children has obvious effect and less related complications,which is worthy of clinical promotion.

关 键 词：儿童 手指挛缩性瘢痕 脉冲染料激光 超脉冲CO_(2)点阵激光 

分 类 号：R622[医药卫生—整形外科]