超脉冲CO2点阵激光联合曲安奈德封闭注射治疗增生性瘢痕的疗效观察

目的评价超脉冲CO2点阵激光联合曲安奈德治疗增生性瘢痕的有效性及安全性。方法广州市皮肤病防治所2018年1月至2019年6月采用CO2点阵激光联合曲安奈德治疗的24例增生性瘢痕患者(观察组)和单用曲安奈德治疗的29例痤疮瘢痕患者(对照组),分别用主观疗效评价和温哥华瘢痕量表(Vancouver Scar Scale,VSS)对两组治疗前后照片分析统计,评估疗效。统计方法采用χ^2检验,两独立样本t检验及单样本t检验。结果治疗后,观察组和对照组总体有效率分别为87.5%(24例)和79.3%(29例),两组差异无统计学意义(χ^2=0.179,P>0.05)。治疗前观察组VSS评分为8.5±3.3,对照组为8.4±3.3,两组差异无统计学意义(t=0.242,P>0.05)。治疗后,观察组VSS评分降低为4.3±2.9,前后比较差异有统计学意义(t=7.391,P<0.05),对照组降低为5.4±2.9,前后比较差异有统计学意义(t=7.657,P<0.05)。两组差值VSS差值d对比,差异有统计学意义(t=2.088,P<0.05)。结论超脉冲CO2点阵激光联合曲安奈德治疗增生性瘢痕疗效确切,安全性高且创伤小。

Evaluation of efficacy of ultra-pulsed CO2 fractional laser combined with tri-amcinolone acetonide for the treatment of hypertrophic scar

Objective To evaluate the combination efficacy of fractional CO2 laser and triamcinolone acetonide in the treatment of hy-pertrophic scars.Methods A retrospective study was conducted.According to the inclusion and exclusion criteria,24 patients with hypertrophic scars receiving fractional CO2 laser combined with triamcinolone acetonide in Guangzhou Institute of Dermatology were enrolled into this study from January 2018 to June 2019.Subjective efficacy evaluation and Vancouver Scar Scale was conducted by two clinically experienced dermatologists to evaluate and compare the clinical efficacy between the 2 groups,based on the clinical photos before and after the treatment.Statistical analysis was done by using chi-square test,t test of two independent samples and t test of single sample.Results After treatment,no significant difference in the total response rate was observed between the observation group(87.5%,24 cases)and control group(79.3%,29 cases;χ^2=0.179,P﹥0.05).Before the treatment,there was no significant difference in theVSS score between the observation group(8.5±3.3)and con-trol group(8.4±3.3,t=0.242,P﹥0.05).After the treatment,the vss score in the observation group and con-trol group significantly decreased into 4.3±2.9 and 5.4±2.9 respectively(t=7.391,7.657,respectively,both P﹤0.05).Conclusion Combination treatment of fractional CO2 laser and triamcinolone acetonide is effective for hypertrophic scars,with high safety and less injuries.