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超脉冲二氧化碳激光疗法与序贯激光及药物治疗减少瘢痕的比较评估。

Assessment of ultra-pulse CO2 laser therapy in comparison to sequential laser and drug treatments for scar reduction.

作者信息

Chen Xiang-Jun, Wu Di, Kang Shu-Xia, Xing Tian-Jiao, Yao Yao, Yu Li, Liang Jun-Qing

机构信息

Department of Plastic and Reconstructive Surgery, Peking University Cancer Hospital Inner Mongolia Hospital, Hohhot, China.

Department of Dermatology and Venereology, Peking University Cancer Hospital Inner Mongolia Hospital, Hohhot, China.

出版信息

Medicine (Baltimore). 2025 Mar 14;104(11):e41819. doi: 10.1097/MD.0000000000041819.

Abstract

Scar management, particularly for early proliferative burn scars, remains a clinical challenge. This study assesses the efficacy of ultra-pulse carbon dioxide (CO2) laser therapy in comparison to sequential laser therapy and pharmacological interventions for scar reduction. A retrospective evaluation was conducted from January 2016 to March 2019 involving 200 patients with early proliferative burn scars treated at the Burn and Plastic Surgery Department of our institution. Participants were assigned to 4 groups: Group A received ultra-pulse CO2 laser therapy, Group B underwent sequential pulsed dye laser therapy, Group C received sequential laser therapy combined with pharmacological treatment, and a control group received no intervention. Clinical outcomes were assessed using the Vancouver Scar Scale (VSS) and the Numeric Pain Rating Scale. Efficacy was evaluated based on scar characteristics and pain scores. Demographic characteristics across all groups were comparable, with no significant differences noted (P > .05). The clinical efficacy assessment revealed that the overall effective rates for Group A, Group B, and Group C were 80.00%, 96.00%, and 98.00%, respectively. Groups B and C not only exhibited significantly higher effective rates but also demonstrated marked improvements in scar characteristics as measured by the VSS, including reduced erythema and thickness. Additionally, pain scores during treatment were lowest in Group C, indicating better tolerability compared to the other modalities (P < .05). Sequential laser therapy improves the clinical efficacy for early proliferative burn scars, enhancing scar characteristics overall. When combined with pretreatment pharmacotherapy, this approach also reduces patient pain during treatment. These results highlight the benefits of integrating sequential laser and drug therapies in scar management.

摘要

瘢痕管理,尤其是针对早期增生性烧伤瘢痕,仍然是一项临床挑战。本研究评估了超脉冲二氧化碳(CO2)激光治疗与序贯激光治疗及药物干预相比在减少瘢痕方面的疗效。对2016年1月至2019年3月期间在我院烧伤整形科接受治疗的200例早期增生性烧伤瘢痕患者进行了回顾性评估。参与者被分为4组:A组接受超脉冲CO2激光治疗,B组接受序贯脉冲染料激光治疗,C组接受序贯激光治疗联合药物治疗,对照组不接受干预。使用温哥华瘢痕量表(VSS)和数字疼痛评分量表评估临床结果。根据瘢痕特征和疼痛评分评估疗效。所有组的人口统计学特征具有可比性,未观察到显著差异(P>0.05)。临床疗效评估显示,A组、B组和C组的总有效率分别为80.00%、96.00%和98.00%。B组和C组不仅有效率显著更高,而且通过VSS测量的瘢痕特征也有明显改善,包括红斑减轻和厚度降低。此外,C组治疗期间的疼痛评分最低,表明与其他治疗方式相比耐受性更好(P<0.05)。序贯激光治疗提高了早期增生性烧伤瘢痕的临床疗效,总体上改善了瘢痕特征。当与预处理药物治疗相结合时,这种方法还可减轻患者治疗期间的疼痛。这些结果突出了在瘢痕管理中整合序贯激光和药物治疗的益处。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e168/11922416/393c85163c61/medi-104-e41819-g001.jpg

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