摘要
目的探讨CO2点阵激光联合注射醋酸泼尼松龙治疗增生性瘢痕的临床疗效。方法选取2018年2月至2019年4月收治于空军军医大学唐都医院的104例增生性瘢痕患者作为研究对象,采用随机数表法将患者随机分为观察组和对照组,每组52例。对照组采用醋酸泼尼松龙注射治疗,观察组在对照组治疗的基础上联合CO2点阵激光治疗,治疗6个月。比较两组患者治疗后的总有效率,治疗前后瘢痕厚度、瘢痕面积、温哥华瘢痕量表(VSS)评分、疼痛视觉模拟评分(VAS)、瘙痒VAS评分、血清血管内皮生长因子(VEGF)含量,以及治疗期间不良反应发生率。结果治疗后,观察组患者的治疗总有效率为96.15%,明显高于对照组的69.23%,差异有统计学意义(P<0.05);观察组和对照组患者的瘢痕厚度[(5.34±1.14)mm vs(9.27±2.08)mm]、瘢痕面积[(1.87±0.42)cm^2 vs(3.29±0.54)cm2]、VSS评分[(6.75±1.33)分vs(8.98±1.48)分]、疼痛VAS评分[(3.27±0.61)分vs(4.66±1.25)分]、瘙痒VAS评分[(1.81±0.36)分vs(2.92±0.45)分]和血清VEGF含量[(1258.41±12.69)μg/L vs(1982.76±19.35)μg/L]比较,观察组明显低于对照组,差异均有统计学意义(P<0.05);观察组患者治疗期间的不良反应发生率为7.69%,明显低于对照组的23.08%,差异有统计学意义(P<0.05)。结论CO2点阵激光联合醋酸泼尼松龙治疗增生性瘢痕可改善瘢痕大小和疼痛瘙痒症状,抑制血管过度增生,提高临床治疗疗效,并具有较好的安全性。
Objective To explore clinical curative effect of CO2 fractional laser combined with prednisolone acetate(PA)injection on hypertrophic scars(HTS).Methods A total of 104 HTS patients who were admitted to Tangdu Hospital of Air Force Military Medical University from February 2018 to April 2019 were enrolled.They were divided into observation group(52 cases)and control group(52 cases)by random number table method.The control group was treated with PA injection,while the observation group was treated with CO2 fractional laser on basis of control group,for 6 months.The total response rate after treatment,scar thickness and area,scores of Vancouwer scar scale(VSS),pain Visual Analogue Scale(VAS)and pruritus VAS,content of serum vascular endothelial growth factor(VEGF)before and after treatment,and incidence of adverse reactions during treatment were compared between the two groups.Results After treatment,total response rate of treatment in observation group was significantly higher than that in control group:96.15%vs 69.23%,P<0.05.The scar thickness,scar area,scores of VSS,pain VAS and pruritus VAS,and content of serum VEGF in observation group were(5.34±1.14)mm,(1.87±0.42)cm^2,(6.75±1.33)points,(3.27±0.61)points,(1.81±0.36)points,(1258.41±12.69)μg/L,significantly lower than(9.27±2.08)mm,(3.29±0.54)cm2,(8.98±1.48)points,(4.66±1.25)points,(2.92±0.45)points,(1982.76±19.35)μg/L in control group(P<0.05).The incidence of adverse reactions during treatment in the observation group was significantly lower than that in control group:7.69%vs 23.08%,P<0.05.Conclusion CO2 fractional laser combined with PA in treatment of HTS can improve scar size,pain and pruritus,inhibit vessels hyperplasia,and improve clinical curative effect,with relatively better safety.
作者
江兰
张衍国
王小霞
王欢
刘涛
JIANG Lan;ZHANG Yan-guo;WANG Xiao-xia;WANG Huan;LIU Tao(Department of Dermatology,the Tangdu Hospital of Air Force Military Medical University,Xi'an 710038,Shaanxi,CHINA)
出处
《海南医学》
CAS
2020年第14期1829-1832,共4页
Hainan Medical Journal
关键词
CO2点阵激光
醋酸泼尼松龙
增生性瘢痕
疗效
不良反应
CO2fractional laser
Prednisolone acetate
Hypertrophic scar
Curative effect
Adverse reaction
