醋酸曲安奈德配合585nm脉冲染料激光治疗增生性瘢痕疗效分析

目的：探讨醋酸曲安奈德联合585nm脉冲染料激光治疗增生性瘢痕的疗效。方法：收集并分析我科2004年1月～2008年12月使用醋酸曲安奈德加585nm脉冲染料激光治疗躯干、四肢及头面部58例增生性瘢痕患者的临床资料。结果：经过3个月的随访,58例增生性瘢痕患者临床治愈12例（占20．7％）,好转39例（占67．2％）,无效7例（占12．1％）,有效率为87．9％。结论：醋酸曲安奈德联合脉冲染料激光治疗是一项简单、有效的治疗方法,应用该方法可减轻患者痛苦和改善外观。     

Combination therapy using non‐ablative fractional laser and intralesional triamcinolone injection for hypertrophic scars and keloids treatment

Combinations of various treatment modalities were shown to be more effective than monotherapy when treating hypertrophic scars and keloids. This study was conducted to assess the effectiveness of combination therapy with non‐ablative fractional laser and intralesional steroid injection. From May 2015 to June 2017, a total of 38 patients with hypertrophic scars or keloids were evaluated. The control group of 21 patients received steroid injection alone, and 17 patients (the combined group) received 1550‐nm erbium‐glass fractional laser treatment and steroid injection simultaneously. The mean number of treatment sessions was statistically fewer in the combined group than in the control group (6.95 vs 5.47, P = .042). There was a significant difference in the patient's scale in the combined group (14.62 vs 22.82, P = .005); however, the observer's scale was not significantly different (17.92 vs 20.55, P = .549). The recurrence rate was 38.1% (8/21) in the control group and 35.3% (6/17) in the combined groups and showed no significant difference (P = .859). However, the mean remission period was statistically longer in the combined group (3.00 months vs 4.17 months, P = .042). Combination therapy with non‐ablative fractional laser and intralesional steroid injection showed better results for the treatment of hypertrophic scars and keloids with fewer treatment sessions, better patient satisfaction, and longer remission periods.     

去炎松-A和5-氟脲嘧啶联合注射治疗增生性瘢痕及瘢痕疙瘩

目的:探索和评价去炎松-A和5-氟脲嘧啶联合注射治疗增生性瘢痕及瘢痕疙瘩的疗效。方法:58例病人随机分为治疗组和对照组。治疗组为应用去炎松-A和5-氟脲嘧啶增生性瘢痕及瘢痕疙瘩内注射,对照组单独用去炎松-A增生性瘢痕及瘢痕疙瘩内注射。比较两组痊愈率和有效率。结果:所有病例随访12～18个月。治疗组和对照组痊愈率分别为75.86%及48.28%,有效率分别为93.1%及72.41%;痊愈率和有效率差异显著。结论:去炎松-A和5-氟脲嘧啶联合注射治疗增生性瘢痕的疗效显著,安全可靠。     

药物注射法治疗60例增生性瘢痕的疗效观察

目的：评价丹参、醋酸曲安奈德、5-氟尿嘧啶、重组人干扰素γ四种药物进行瘢痕内注射治疗烧伤后增生性瘢痕的效果。方法：回顾本院自2005年7月～2008年6月,60例烧伤后增生性瘢痕患者行瘢痕内药物注射治疗的临床资料,运用统计学方法分析患者的治疗效情况。结果：四个治疗组的疗效总评分在治疗后的变化较治疗前均有显著差异（P〈0.01）;在疗效方面,重组人干扰素γ组〉5-氟尿嘧啶组〉丹参组〉醋酸曲安奈德组（P〈0.05）。结论：对于烧伤后增生性瘢痕的患者,四种药物注射治疗均是确切有效的方法。在单独应用一种药物进行治疗时,重组人干扰素γ的效果比醋酸曲安奈德、丹参更为有效,5-氟尿嘧啶比醋酸曲安奈德效果更好。     

无针注射器治疗瘢痕疙瘩的疗效研究

目的:探究对比常规注射方法与无针注射曲安奈德治疗瘢痕疙瘩的临床治疗效果。方法:选取2018年8月至2019年2月笔者医院收治的50例具有明显临床症状的瘢痕疙瘩患者,使用随机数表法将入组患者分为两组,1ml注射器组和无针注射器组,均进行瘢痕内曲安奈德注射治疗,每位患者行4次注射治疗,每次间隔时间1周,观察对比两组患者瘢痕大小、温哥华瘢痕量表评分、瘢痕总体厚度及注射疼痛评分变化情况。结果:两组患者在接受4次治疗后,其瘢痕长度、宽度、深度、瘢痕量表评分等均有显著改善;无针注射器组对瘢痕的宽度和柔软度的改善程度优于对照组,差异有统计学意义(P<0.05)。结论:使用曲安奈德注射治疗瘢痕时,无针注射组对比有针注射组在减轻瘢痕宽度以及改善瘢痕柔软度方面具有明显优势,在改善瘢痕总体厚度方面与常规注射方法无明显差别。     

Fractional laser‐assisted delivery of methyl aminolevulinate: Impact of laser channel depth and incubation time

Background and Objectives

Pretreatment of skin with ablative fractional lasers (AFXL) enhances the uptake of topical photosensitizers used in photodynamic therapy (PDT). Distribution of photosensitizer into skin layers may depend on depth of laser channels and incubation time. This study evaluates whether depth of intradermal laser channels and incubation time may affect AFXL‐assisted delivery of methyl aminolevulinate (MAL).

Materials and Methods

Yorkshire swine were treated with CO₂ AFXL at energy levels of 37, 190, and 380 mJ/laser channel and subsequent application of MAL cream (Metvix®) for 30, 60, 120, and 180 minutes incubation time. Fluorescence photography and fluorescence microscopy quantified MAL‐induced porphyrin fluorescence (PpIX) at the skin surface and at five specific skin depths (120, 500, 1,000, 1,500, and 1,800 µm).

Results

Laser channels penetrated into superficial (～300 µm), mid (～1,400 µm), and deep dermis/upper subcutaneous fat layer (～2,100 µm). Similar fluorescence intensities were induced at the skin surface and throughout skin layers independent of laser channel depth (180 minutes; P < 0.19). AFXL accelerated PpIX fluorescence from skin surface to deep dermis. After laser exposure and 60 minutes MAL incubation, surface fluorescence was significantly higher compared to intact, not laser‐exposed skin at 180 minutes (AFXL‐MAL 60 minutes vs. MAL 180 minutes, 69.16 a.u. vs. 23.49 a.u.; P < 0.01). Through all skin layers (120–1,800 µm), laser exposure and 120 minutes MAL incubation induced significantly higher fluorescence intensities in HF and dermis than non‐laser exposed sites at 180 minutes (1,800 µm, AFXL‐MAL 120 minutes vs. MAL 180 minutes, HF 14.76 a.u. vs. 6.69 a.u. and dermis 6.98 a.u. vs. 5.87 a.u.; P < 0.01).

Conclusions

AFXL pretreatment accelerates PpIX accumulation, but intradermal depth of laser channels does not affect porphyrin accumulation. Further studies are required to examine these findings in clinical trials. Lasers Surg. Med. 44: 787–795, 2012. © 2012 Wiley Periodicals, Inc.     

1565 nm非剥脱点阵激光治疗瘢痕疙瘩与增生性瘢痕

增生性瘢痕以及瘢痕疙瘩的治疗是亟待解决的医学难题。1565 nm非剥脱点阵激光是瘢痕治疗全新的治疗方法,临床尝试使用1565 nm非剥脱点阵激光来治疗增生期的增生性瘢痕以及瘢痕疙瘩的确有明显的治疗作用。非剥脱性点阵激光造成瘢痕组织局部的热效应,这种热效应,在不破坏组织胶原支架结构,不引起较强炎症反应基础上,能够导致瘢痕局部的成纤维细胞增殖受到抑制,甚至能够促进成纤维细胞的凋亡,瘢痕逐渐萎缩,达到治疗目的。     

点阵激光治疗面颈部浅表性瘢痕疗效观察

目的:总结点阵激光治疗面颈部浅表性瘢痕的-临床经验并观察其临床疗效.方法:采用点阵激光治疗不同原因所致面颈部浅表性瘢痕,根据疗效评定标准对治疗效果进行评价.结果:共治疗50例,一次治疗后的总显效率为62%.点阵激光治疗后创面愈合时间为5～14天,平均9天,无感染、新生瘢痕、明显色素沉着、色素减退等较严重并发症.结论:点阵激光治疗面颈部浅表性瘢痕疗效艮好.     

铒玻璃1540nm点阵激光治疗面部瘢痕的疗效观察

目的:评估Lux 1540nm铒玻璃点阵激光治疗面部瘢痕的临床疗效。方法:面部瘢痕患者60例,接受1 540nmnm铒玻璃点阵激光治疗,每隔4周治疗1次,共治疗4次,评估治疗后疗效和不良反应。结果:60例患者中痊愈14例(23.33%),显效27例(45.00%),有效12例(20.00%),无效7例(11.67%),总有效率88.33%。不良反应为治疗即刻疼痛、红斑、水肿、炎症后色素沉着。结论:Lux 1 540nm铒玻璃点阵激光治疗面部瘢痕安全、有效。     

Argon and carbon dioxide laser treatment of hypertrophic and keloid scars

Laser physiology has shown that while wound healing is generally excellent after laser impaction, it nevertheless is delayed. It is thought that this factor may be important in the treatment of hypertrophic and keloid scars. These scars have been treated in a variety of ways with the laser, and the results, which have been good, are reported. A possible explanation of the complex mode of action has been given. It is thought that more work should be undertaken in this field.     

点阵铒激光治疗面部各种瘢痕的疗效及影响因素分析

目的:观察应用点阵铒激光治疗面部各种瘢痕的疗效,并对影响疗效的各种因素进行分析。方法:应用点阵铒激光对132例面部瘢痕患者皮损进行磨削、大范围平扫,分析对比依据不同影响因素分组后各组显效率差异,探索对治疗效果有影响的相关因素。结果:所有患者治疗后随访6个月,有效率97.8%,显效率85.7%,无严重不良反应。患者病史长短、皮损的临床分型、病损程度各组显效率差异有统计学意义(P<0.05),性别等其他因素对疗效无影响。结论:点阵铒激光治疗面部瘢痕疗效好,不良反应小,皮损稳定后及早治疗预后较好,皮损程度轻者预后较好,不同临床分型治疗效果不同。     

强脉冲光联合曲安奈德皮损内封闭及外用疤克软膏治疗增生性瘢痕疗效观察

目的：观察强脉冲光联合曲安奈德及疤克软膏治疗增生性瘢痕的,临床疗效。方法：2010年1O月-2011年5月,笔者科室应用强脉冲光联合曲安奈德及疤克软膏治疗增生性瘢痕患者30例,年龄19-52岁,病程1-16月,强脉冲光及曲安奈德治疗间隔期为2个月,治疗次数3-5次,治疗间隔期外涂疤克软膏。结果：30例患者平均治疗4.3次,根据疗效评定标准,显效11例,有效18例,无效1例。结论：强脉冲光联合曲安奈德及疤克软膏治疗增生性瘢痕,治疗间期长,次数少,在瘢痕治疗的美容效果以及远期稳定性方面都取得了较满意的疗效,是瘢痕美容修复的有效手段之一。     

得宝松联合丹芎瘢痕涂膜治疗面颈部增生性瘢痕疗效观察

目的:观察得宝松与丹芎瘢痕涂膜联合应用治疗面、颈部增生性瘢痕的临床疗效。方法:治疗组采用得宝松瘢痕内注射(注射液配方:得宝松和2%利多卡因配比1:1)联合丹芎瘢痕涂膜外用治疗;对照组单纯采用得宝松瘢痕内注射治疗,分别进行对比分析两组痊愈率和有效率。结果:治疗组和对照组的痊愈率分别为63.1%、44.6%,经比较χ2=4.46,P<0.05,差异有统计学意义;有效率分别为95.4%、84.6%,两组相比较χ2=4.21,P<0.05,差异有统计学意义。结论:得宝松、丹芎瘢痕涂膜联合治疗面部增生性瘢痕疗效优于单纯得宝松瘢痕内注射。     

Treatment of keloids and hypertrophic scars with an argon laser

A report is given on the treatment of keloids and hypertrofic scars using an argon laser. Of the 45 patients who participated, only three patients had a diminishing of over 50%, and 40 patients were classified as obtaining slight improvement, which means a diminishing of between 20 and 50% of the original keloid. Twenty-seven patients showed no change after treatment with the argon laser and one patient had a poorer result, due to a complication after the last treatment. Directly after treatment, most keloids showed an obvious shrinkage. After several days, however, the keloids became the same size as before treatment. Decrease of tension of the skin after treatment seems to influence the result favorably. We find the best response to treatment with an argon laser in long narrow keloids (hypertrofic scars). In general, the results are disappointing, especially because until now the literature claims good results on this subject.