摘要
目的观察CO2点阵激光分别联合复方倍他米松和A型肉毒素治疗增生性瘢痕(hypertrophic scar,HS)的临床疗效。方法选择2015年1月至2018年2月,HS患者138例,采用随机数字表法分为三组,每组患者46例。A组采用CO2点阵激光治疗;B组采用CO2点阵激光联合复方倍他米松治疗;C组采用CO2点阵激光联合A型肉毒素治疗。所有患者治疗后1,6和12个月随访,对比疗效、瘢痕厚度、瘢痕面积、瘢痕评分、血清肿瘤坏死因子-α(Tumor necrosis factor-α,TNF-α)、转化生长因子-β1(Transforming growth factor-β1,TGF-β1)、基质金属蛋白酶-9(Matrix metalloproteinase-9,MMP-9)水平、不良反应发生率以及复发率。结果治疗后6个月,C组总有效率高于A组、B组(P<0.05);C组瘢痕厚度、瘢痕面积、瘢痕评分低于A组和B组(P<0.05);治疗后1个月,三组血清TNT-α、TGF-β1和MMP-9水平低于治疗前(P<0.05)。治疗后12个月,C组复发率低于A组和B组(P<0.05);三组患者不良反应发生率比较,差异无统计学意义(P>0.05)。结论CO2点阵激光联合A型肉毒素治疗HS疗效好、安全性高、复发率低。
objective To compare the clinical efficacy of CO2 dot array laser plus compound betamethasone and Type A botulinum toxin in treating hypertrophic scars(HS).Methods Totally 138 HS patients were randomly divided into three groups,each consisting of 46 cases.The patients in Group A were treated with CO2 lattice laser,those in Group B with CO2 lattice laser plus compound beatamethasone,and those in Group C with CO2 lattice laser plus Type A botulinum toxin.All the patients were followed up for 6 and 12 months after the treatment,and the efficacy,scar thickness,scar area,scar score,serum tumor necrosis factor-α(TNF-α),transforming growth factor-β1(TGF-β1),matrix metalloproteinase-9(MMP-9),adverse reaction rate and recurrence rate were observed and recorded.Results Six months after treatment,the total effective rate of Group C was higher than that of Group A and Group B(P<0.05).One month after treatment,serum TNF-α,TGF-β1 and MMP-9 level lower than before treatment(P<0.05).Twelve months after treament,and recurrence rate of Group C were lower than those of Group A and Group B(P<0.05).There was no significant difference in the rates of adverse reactions among the three groups(P>0.05).Conclusions Featuring high safety and low recurrence rate,the combined application of CO2 dot matrix laser and Type A botulinum toxin is superior to sole CO2 dot array laser treatment and the combination of CO2 dot matrix laser and compound betamethasone in treating hypertrophic scars.
作者
胡太平
陶剑光
周丽娟
李大鹏
刘菲菲
HU Tai-ping;TAO Jian-guang;ZHOU Li-juan;LI Da-peng;LIU Fei-fei(Department of Burn,Plastic and Cosmetic,Handan Central Hospital of Hebei Province,Handan 056008,China)
出处
《中国激光医学杂志》
CAS
2020年第4期181-187,共7页
Chinese Journal of Laser Medicine & Surgery
基金
河北省医学科学研究重点课题(08484)。
关键词
激光
复方倍他米松
A型肉毒素
增生性瘢痕
Laser
Compound betamethasone
Type A botulinum toxin
Hypertrophic scars
