长脉冲染料激光联合局部封闭治疗面颈部增生性瘢痕疗效分析  

Efficacy Analysis of Long Pulsed Dye Laser Combined with Local Sealing on Faciocervical Hypertrophic Scars

作　　者：赵文利 刘玲玲 石雪芹 邹晓梅 韩军涛 ZHAO Wenli;LIU Lingling;SHI Xueqin;ZOU Xiaomei;HAN Juntao(Department of Burn and Skin Surgery,the First Affiliated Hospital of the Chinese People's Liberation Army Air Force Military Medical University,Xi'an 710032,Shaanxi,China;Outpatient Department,the First Affiliated Hospital of the Chinese People's Liberation Army Air Force Military Medical University,Xi'an 710032,Shaanxi,China)

机构地区：[1]中国人民解放军空军军医大学第一附属医院烧伤与皮肤外科,陕西西安710032 [2]中国人民解放军空军军医大学第一附属医院门诊部,陕西西安710032

出　　处：《中国美容医学》2024年第3期96-100,共5页Chinese Journal of Aesthetic Medicine

摘　　要：目的:探究长脉冲染料激光联合局部封闭治疗面颈部增生性瘢痕的效果及对皮肤屏障功能、Sawada分级和温哥华瘢痕量表(Vancouver scar scale,VSS)评分的影响。方法:选取2021年1月-2022年8月于笔者医院门诊就诊的71例面颈部增生性瘢痕患者,按照随机数字表法分为对照组(n=35例,局部封闭治疗)与观察组(n=36,长脉冲染料激光联合局部封闭治疗),所有患者治疗结束后随访12个月,评估疗效并比较两组患者治疗前后瘢痕皮肤经皮水分丢失量、角质层含水量、红斑指数、临床症状Sawada分级、VSS评分及不良反应发生情况。结果:观察组治疗总体有效率为94.44%,高于对照组的77.14%(P<0.05);观察组治疗后皮肤经皮水分丢失量及红斑指数低于对照组,角质层含水量高于对照组(P<0.05);观察组治疗后瘢痕颜色、高度、硬度、瘙痒程度、触痛感觉评分低于对照组(P<0.05);观察组治疗后血管分布、柔软程度、色泽、厚度评分低于对照组(P<0.05);观察组疼痛、轻度色素减退、萎缩性瘢痕、红肿及总体不良反应发生率低于对照组(P<0.05)。结论:长脉冲染料激光联合局部封闭治疗面颈部增生性瘢痕患者,可明显改善其皮肤屏障功能及瘢痕情况,提升疗效,值得临床推广使用。Objective To explore the effect of long pulsed dye laser combined with local sealing in the treatment of faciocervical hypertrophic scars and its influence on skin barrier function, Sawada grading and Vancouver Scar Scale(VSS) score. Methods 71 patients with faciocervical hypertrophic scars who were treated in outpatient department of the hospital between January 2021 and August 2022 were selected and divided into control group(n=35, local sealing treatment) and observation group(n =36, long pulsed dye laser combined with local sealing) by means of the random number table method. All patients were followed up for 12 months after the end of treatment. The efficacy was evaluated, and the transdermal water loss of scar skin,water content of stratum corneum, erythema index, clinical symptom Sawada grading and VSS score before and after treatment and occurrence of adverse reactions were compared between both groups. Results The total effective rate of treatment in observation group was higher than that in control group(94.44% vs 77.14%)(P<0.05). After treatment, the transdermal water loss and erythema index in observation group were lower,while the water content of stratum corneum was higher compared to control group(P<0.05). After treatment, the scores of scar color, height, hardness, itching degree and tenderness were lower in observation group than those in control group(P<0.05). After treatment, the scores of blood vessel distribution, softness degree, color and thickness in observation group were lower than those in control group(P<0.05). The incidence rates of pain,mild hypopigmentation, atrophic scars and redness and swelling and total incidence rate of adverse reactions were lower in observation group compared with those in control group(P<0.05). Conclusion For patients with faciocervical hypertrophic scars, the application of long pulsed dye laser combined with local sealing treatment can significantly improve the skin barrier function and scars, enhance the efficacy. It can be used for clinical promotion and

关 键 词：长脉冲染料激光 局部封闭 面颈部 增生性瘢痕 

分 类 号：R619.6[医药卫生—外科学]