摘要
目的探讨超脉冲二氧化碳点阵激光的超脉冲模式联合DeepFX模式／ScaarFX模式治疗面颈部增生性瘢痕患者的效果。方法2012年1月-2015年1月，湖南省人民医院收治符合入选标准的158例面颈部增生性瘢痕患者。清洁瘢痕区域并给予复方利多卡因乳膏表面麻醉后，采用超脉冲二氧化碳点阵激光中的超脉冲模式（能量为150～175mJ，频率为40Hz，孔与孔之间距离为4mm或5mm，每孔治疗时间为2s或3s）治疗。对轻度瘢痕，加用DeepFX模式（能量为30～50mJ，频率为300Hz，密度为5％）治疗；对中、重度瘢痕，加用ScaarFX模式（能量为80～150mJ，频率为300Hz，密度为3％）治疗。上述治疗共进行3次，每次间隔3个月，每次时长10～15min。每次治疗后创面予以保湿、防晒处理。首次治疗前及3次治疗后半年，使用温哥华瘢痕量表（VSS）和北卡罗来纳大学瘢痕量表评估疗效；3次治疗后半年，统计患者对疗效满意度和误工时间。记录整个治疗过程中的不良反应。对数据行t检验。结果（1）治疗3次后半年，患者的VSS评分为（3．1±1．0）分，明显低于首次治疗前[（9．4±1．8）分，t=53．096，P〈0．05]；患者的北卡罗来纳大学瘢痕量表评分为（1．6±0．7）分，亦明显低于首次治疗前[（8．0±1．4）分，t=63．730，P〈0．05]。（2）治疗3次后半年，150例患者对疗效感到非常满意，6例患者满意，2例患者较为满意。患者的误工时间为10～15（10．5±0．3）d。（3）治疗期间，5例患者出现轻微红斑，自行消失；6例患者首次治疗后2周出现色素沉着，2例患者首次治疗后3d出现瘙痒、红疹，均通过药物治疗改善。结论超脉冲二氧化碳点阵激光的超脉冲模式联合DeepFX／ScaarFX模式治疗患者面颈部增生性瘢痕，疗效确切，不良反应少，值得临床推广应用。
Objective To explore the clinical effects of ultra pulse mode of ultra pulse carbon dioxide fractional laser combined with Deep FX mode or Scaar FX mode on the treatment of patients with hypertrophic scars on face and neck. Methods One hundred and fifty-eight patients with hypertrophic scars on face and neck who met the inclusion criteria were admitted to Hunan Provincial People＇s Hospital from January 2012 to January 2015. Firstly, the scar areas were cleaned and given compound lidocaine cream for surface anesthesia. Then the scar areas were treated with ultra pulse mode of ultra pulse carbon dioxide fractional laser, with energy from 150 to 175 mJ, frequency of 40 Hz, hole to hole distance of 4 mm or 5 ram, and the treatment time of each hole of 2 s or 3 s. For mild scar, Deep FX mode was added for treatment with energy from 30 to 50 mJ, frequency of 300 Hz, and density of 5% ; for moderate and severe scar, Scaar FX mode was additionally used for therapy, with energy from 80 to 150 mJ, frequency of 300 Hz, and density of 3% . The above-mentioned treatments were performed per three months, totally for 3 times, 10 - 15 rain per treatment. After each treatment, wounds were moisturized and given sun protection. Before the first treatment and 6 months after treatment of 3 times, the curative effect was assessed by Vancouver Scar Scale （VSS） and University of North Carolina Scar Scale. gree of patient and loss of working time were recorded Six months after treatment of 3 times, satisfaction de The adverse effects of whole treatment course were recorded. Data were processed with t test. Results （ 1 ） Six months after treatment of 3 times, VSS score of patients was （3.1 ± 1.0） points, which was significantly lower than that before the first treatment [ （9.4 ± 1.8） points, t = 53. 096, P 〈 0.05 ] ; University of North Carolina Scar Scale score of patients was （ 1.6± 0. 7） points, which was significantly lower than that before the first treatment [ （8.0±1.4） points, t = 63. 730, P 〈0.05 ]. （2） Six months after treatment of 3 times, 150 patients were very satisfied with the curative effect, 6 patients were satisfied, and 2 patients were relatively satisfied. The loss of working time of patients was 10 - 15 （ 10.5±0. 3） d. （3） During the treatment, mild erythema appeared in 5 patients which disappeared without treatment; pigmentation appeared in 6 patients 2 weeks after the first treatment, and pruritus and rash appeared in 2 patients 3 days after the first treatment, which were all improved with pharmaceutical therapy. Conclusions Ultra pulse mode of ultra pulse carbon dioxide fractional laser combined with Deep FX mode or Scaar FX mode has definitely clinical effect on patients with hypertrophic scars on face and neck with few adverse effects, which is worth to popularize and apply for clinic.
出处
《中华烧伤杂志》
CAS
CSCD
北大核心
2016年第8期474-478,共5页
Chinese Journal of Burns
