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[复合激光技术联合曲安奈德多点微量注射治疗小儿烧伤增生性瘢痕的效果]

[Effects of composite laser technique combined with multipoint microinjection of triamcinolone acetonide in the treatment of hypertrophic scars in burn children].

作者信息

Lei Y, Tan J, Ouyang H W, Liu X J, Yu Y L

机构信息

(1st Affiliated Hospital of Hunan Normal University), Changsha 410005, China.

出版信息

Zhonghua Shao Shang Yu Chuang Mian Xiu Fu Za Zhi. 2022 Sep 20;38(9):810-815. doi: 10.3760/cma.j.cn501225-20220519-00192.

Abstract

To explore the effects of pulsed dye laser (PDL) and ultra-pulsed fractional carbon dioxide laser (UFCL) combined with multipoint microinjection of triamcinolone acetonide in the treatment of red hypertrophic scar at early stage in burn children. A retrospective cohort before-after control study in the same patients was conducted. From February 2019 to December 2020, a total of 67 burn children who met the inclusion criteria (32 males and 35 females, aged 1 to 12 years) with red hyperplastic scar at early stage, were treated in Hunan Provincial People's Hospital (1 Affiliated Hospital of Hunan Normal University). All the children were treated with composite laser technique (PDL and UFCL) combined with triamcinolone acetonide (hereinafter referred to as combined treatment). After 2 months, they received the second combined treatment. Before the first combined treatment and 6 months after the last combined treatment, the scar of children was evaluated with the patient and observer scar assessment scale (POSAS) by physicians and family members. Six months after the last combined treatment, the satisfaction of the patients' family members with the efficacy was recorded and the overall satisfaction rate was calculated. Adverse reactions were recorded throughout the treatment process. Data were statistically analyzed with paired sample test. Six months after the last combined treatment, the POSAS scores of children on the thickness, blood vessels distribution, color, surface roughness, texture, scope, and overall evaluation of scar evaluated by the physicians, and the POSAS scores of children on the color, degree of pain, degree of itching, hardness, thickness, shape and size, and overall evaluation of scar evaluated by the family members were significantly lower than those before the first combined treatment (with values of 17.32, 16.73, 15.00, 14.91, 19.62, 28.74, 29.83, 17.43, 20.52, 29.01, 28.82, 24.91, 20.30, and 42.13, respectively, <0.01). Six months after the last combined treatment, 62 (93%), 3 (4%), and 2 (3%) children's family members were very satisfied, satisfied, and relatively satisfied with the treatment effect, respectively, and the overall satisfaction rate was 97% (65/67). Six months after the last combined treatment, no scar thickening or infection occurred in all the wounds of children. Composite laser technique combined with multipoint microinjection of triamcinolone acetonide in the treatment of red hypertrophic scar at early stage in burn children can improve the appearance and texture of scar, reduce scar pain and pruritus, with high satisfaction of children's family members to the treatment effect and less adverse reactions.

摘要

探讨脉冲染料激光(PDL)联合超脉冲分数二氧化碳激光(UFCL)及多点注射曲安奈德治疗小儿烧伤早期红色增生性瘢痕的效果。对同一批患者进行回顾性队列前后对照研究。2019年2月至2020年12月,湖南省人民医院(湖南师范大学附属第一医院)共收治67例符合纳入标准的小儿烧伤早期红色增生性瘢痕患者(男32例,女35例,年龄1至12岁)。所有患儿均采用复合激光技术(PDL和UFCL)联合曲安奈德(以下简称联合治疗)。2个月后进行第二次联合治疗。在首次联合治疗前及末次联合治疗后6个月,由医生和家属采用患者及观察者瘢痕评估量表(POSAS)对患儿瘢痕进行评估。末次联合治疗后6个月,记录患儿家属对疗效的满意度并计算总体满意率。记录整个治疗过程中的不良反应。采用配对样本检验进行统计学分析。末次联合治疗后6个月,医生评估患儿瘢痕的厚度、血管分布、颜色、表面粗糙度、质地、范围及总体评估的POSAS评分,以及家属评估患儿瘢痕的颜色、疼痛程度、瘙痒程度、硬度、厚度、形状和大小及总体评估的POSAS评分均显著低于首次联合治疗前(分别为17.32、16.73、15.00、14.91、19.62、28.74、29.83、17.43、20.52、29.01、28.82、24.91、20.30和42.13,P<0.01)。末次联合治疗后6个月,患儿家属对治疗效果非常满意、满意及较满意的分别为62例(93%)、3例(4%)和2例(3%),总体满意率为97%(65/67)。末次联合治疗后6个月,患儿所有创面均未出现瘢痕增厚或感染。复合激光技术联合多点注射曲安奈德治疗小儿烧伤早期红色增生性瘢痕可改善瘢痕外观及质地,减轻瘢痕疼痛和瘙痒,患儿家属对治疗效果满意度高,不良反应少。

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