摘要
目的探讨强脉冲光(intense pulsed light,IPL)联合硅凝胶贴对早期增生性瘢痕联合干预的临床效果。方法回顾性分析2015年6月至2015年10月,瘢痕患者80例,根据不同的治疗方法分为3组,其中A组30例,使用硅凝胶贴外贴3个月;B组患者25例,单用IPL治疗,输出波长560 nm,双脉宽2. 4~3. 0 ms和4. 6~5. 0 ms;间隔30 ms,能量20~30 J/cm2,共治疗2~3次,每次间隔时间4周;C组患者25例,采用IPL联合硅凝胶贴外贴治疗。治疗结束后1年随访,拍摄治疗区域治疗前后的照片并详细记录疼痛、瘙痒等不适症状。三组瘢痕治疗前后采用美容评估评级瘢痕量表(Scar Cosmesis Assessment and Rating,SCAR)进行比较分析,并记录不良反应的发生情况。结果三组患者在治疗后均取得了较好的治疗效果,SCAR评分较治疗前均明显下降(P<0. 05),其中B组、C组的红斑项目治疗效果更好(P<0. 01)。治疗后,B组、C组与A组比较效果更好,SCAR评分和红斑项目差异均具有统计学意义(P<0. 05)。结论 IPL联合硅凝胶贴的早期联合干预能够改善增生性瘢痕,尤其体现在改善瘢痕红斑方面,临床不良反应率低,值得临床推广。
Objective To investigate the clinical effect of intense pulsed light(IPL)combined with silicone dressing on the early intervention ofhypertrophic scars.Methods Totally 80 patients with hypertrophic scar admitted from Jun. to Oct. 2015 were selected and divided into three groups:Group A,B and C. The patients(30)in Group A were treated with silicone dressing for 3 months,those(25)in Group B with IPL(2~3 times at an interval of 4 weeks)and those(25)in Group C with silicone dressing and IPL(2~3 times at an interval of 4 weeks).The photographs of the treatment areas were taken and discomfort symptoms such as pain and itching were recorded. The scarcosmesis assessment and rating(SCAR)scores and incidence of adverse reactions before and after the treatment were comparedamong the three groups.Results For all the groups,good therapeutic effect was achieved,and the differences of the SCAR scores and erythema indexesbefore and after the therapy were statistically significant(P<0. 05). After the treatment,significant differences existed both betweenGroup B and A and Group C and A(P<0. 05). The decrease of erythema index of Group B was sharper than that of Group C,and thedifference was statistically significant(P<0. 05).Conclusions The early intervention of hypertrophic scars with IPL plus silicone dressing will improve hypertrophic scars,especiallyscar erythema. Having a low occurrence rate of adverse reactions,it is worthy of clinical promotion.
作者
丁架月
李华
DING Jia-yue;LI Hua(Department of burn and plastic surgery,Sir Run Run Shao Hosipital,hangzhou 310008,China;Lishui PeopleHosipital)
出处
《中国激光医学杂志》
CAS
2019年第5期261-265,298,299,共7页
Chinese Journal of Laser Medicine & Surgery
基金
浙江省中医药科技计划（2018ZB077）
丽水市人民医院院级课题（2017CTB016)
关键词
强脉冲光
增生性瘢痕
早期干预
激光
Intense pulsed light
Hypertrophic scar
Early intervention
Laser
