点阵CO_(2)激光联合曲安奈德治疗儿童面部早期增生性瘢痕的美学效果评价  

Aesthetic Effect of Fractional CO_(2)Laser Combined with Triamcinolone Acetonide Acetate in the Treatment of Early-stage Facial Hypertrophic Scars in Pediatric Patients

作　　者：陈白烨 赵帅[2] 王学明 CHEN Baiye;ZHAO Shuai;WANG Xueming(Department of Plastic Surgery,Fujian Children's Hospital,Fuzhou 350000,Fujian,China;Department of Breast Surgery,Fujian Maternal and Child Health Hospital,Fuzhou 350001,Fujian,China)

机构地区：[1]福建省儿童医院整形外科,福建福州350000 [2]福建省妇幼保健院乳腺科,福建福州350001

出　　处：《中国美容医学》2024年第12期15-20,共6页Chinese Journal of Aesthetic Medicine

基　　金：福建省2022年自然科学基金联合资金等科技项目(编号:2022J011068)。

摘　　要：目的:探究点阵CO_(2)激光联合微孔透皮导入醋酸曲安奈德(Triamcinolone acetonide acetate,TAA)治疗儿童面部早期增生性瘢痕的美学效果。方法:选择2020年1月-2022年12月笔者医院收治的158例面部早期增生性瘢痕患儿,按照治疗方法不同分为对照1组(n=51,水光注射仪导入TAA治疗)、对照2组(n=54,点阵CO_(2)激光治疗)和研究组(n=53,点阵CO_(2)激光+微孔透皮导入TAA治疗),比较各组临床疗效、美学效果[双向瘢痕评估量表(POSAS)]、血清瘢痕形成因子[转化生长因子-β1(TGF-β1)、骨形态发生蛋白-7(BMP-7)、血管内皮生长因子(VEGF)]水平、不良反应、总治疗费用和家长满意度。结果:研究组临床总有效率为98.11%,高于对照1组的84.31%和对照2组的87.04%(P<0.05);治疗后各组观察者瘢痕评估(OSAS)总体评分、患者瘢痕评估(PSAS)总体评分较治疗前均明显改善,且研究组OSAS量表中瘢痕色素沉着、总体评分低于对照1组、对照2组,PSAS量表中疼痛、总体评分低于对照1组、对照2组(P<0.05);治疗后各组血清TGF-β1、BMP-7、VEGF均降低,且研究组低于对照1组、对照2组(P<0.05);研究组总治疗费用低于对照1组和对照2组(P<0.05);各组不良反应发生率比较差异无统计学意义(P>0.05);研究组患儿家长满意度为100.00%,高于对照1组的88.24%和对照2组的90.74%(P<0.05)。结论:点阵CO_(2)激光联合曲安奈德治疗儿童面部早期增生性瘢痕能明显降低瘢痕形成因子水平,减少瘢痕色素沉着,增加美学效果,临床效果满意。Objective To explore the aesthetic effect of fractional CO_(2)laser combined with transdermal delivery of triamcinolone acetonide aqueous(TAA)in the treatment of early-stage facial hypertrophic scars in pediatric patients.Methods One hundred and fifty-eight pediatric patients with early-stage facial hypertrophic scars in the author's hospital from January 2020 to December 2022 were enrolled,and therapy using a water light injection device(control group 1,n=51),fractional CO_(2)laser(control group 2,n=54)or fractional CO_(2)laser plus transdermal delivery of TAA(study group,n=53).Then the clinical efficacy,aesthetic effect[patient and observer scar assessment scale(POSAS)],serum scar growth factors[transforming growth factor-β1(TGF-β1),bone morphogenetic protein-7(BMP-7),vascular endothelial growth factor(VEGF)],adverse reactions,total medical costs and parental satisfaction were compared among three groups.Results The total efficacy rate was 98.11%in study group,which was higher than 84.31%in control group 1 and 87.04%in control group 2,with statistical difference(P<0.05).An improvement was detected in overall scores of observer scar assessment scale(OSAS)and patient scar assessment scale(PSAS)scores in both groups after treatment(P<0.05).Furthermore,study group had lower pigmentation score and overall score in OSAS as well as lower pain score and overall score in PSAS than those in control group 1 and control group 2(all P<0.05).A reduction in serum levels of TGF-β1,BMP-7 and VEGF was observed in all three groups after treatment,and the reduction was most notable in study group than in control group 1 and control group 2(P<0.05).The medical cost in study group was lower than that in control group 1 and that in control group 2(P<0.05).The adverse reaction group yielded no statistical difference between two groups(P>0.05).The patient satisfaction rate was 100.00%in study group,which was higher than 88.24%in control group 1 and 90.74%in control group 2(P<0.05).Conclusion Application of fractional CO_(2)laser com

关 键 词：点阵CO_(2)激光 曲安奈德 增生性瘢痕 美学效果 

分 类 号：R619.6[医药卫生—外科学]