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一种使用非剥脱性分次激光联合病灶内注射曲安奈德治疗小儿增生性烧伤瘢痕的个体化动态治疗策略。

An individualized strategy of dynamic therapy using non-ablative fractional laser combined with intralesional triamcinolone injection for pediatric hypertrophic burn scars.

作者信息

Du Haojuan, Qiu Lin, Zhou Rong

机构信息

Children's Hospital of Chongqing Medical University, Chongqing, China.

出版信息

Lasers Med Sci. 2025 Apr 21;40(1):203. doi: 10.1007/s10103-025-04452-5.

Abstract

An effective treatment strategy for pediatric hypertrophic burn scars has yet to be established. This study aimed to evaluate the efficacy and safety of a dynamic treatment approach that combines non-ablative fractional laser (NAFL) therapy with intralesional triamcinolone (TAC) injections for post-burn hypertrophic scars in children. Participants were assigned to three groups: the combination treatment group (22 patients), the laser-only group (19 patients), and the triamcinolone-only group (17 patients). After a 6-month follow-up period, all three groups demonstrated a significant decrease in the modified Vancouver Scar Scale (m-VSS) scores compared to their pre-treatment values, with the combination group experiencing the most substantial reduction. The median post-treatment m-VSS score in the combination group was significantly lower than in the laser-only and triamcinolone-only groups (5 vs. 7 vs. 9, P = 0.003). The obvious effective rate of combination group was 54.5%, significantly higher than that of laser group (26.3%) and injection group (23.5%) (P = 0.012). Combining non-ablative fractional laser therapy with intralesional triamcinolone injections is an effective and safe treatment for post-burn hypertrophic scars in children. This approach significantly alleviates pain and itching, resulting in high levels of satisfaction among both physicians and patients, warranting clinical recommendation.

摘要

目前尚未确立针对小儿肥厚性烧伤瘢痕的有效治疗策略。本研究旨在评估非剥脱性分数激光(NAFL)治疗联合病灶内注射曲安奈德(TAC)的动态治疗方法对儿童烧伤后肥厚性瘢痕的疗效和安全性。将参与者分为三组:联合治疗组(22例患者)、单纯激光组(19例患者)和单纯曲安奈德组(17例患者)。经过6个月的随访期,与治疗前相比,所有三组的改良温哥华瘢痕量表(m-VSS)评分均显著降低,联合治疗组降低最为显著。联合治疗组治疗后的m-VSS评分中位数显著低于单纯激光组和单纯曲安奈德组(分别为5、7和9,P = 0.003)。联合治疗组的显效率为54.5%,显著高于激光组(26.3%)和注射组(23.5%)(P = 0.012)。非剥脱性分数激光治疗联合病灶内注射曲安奈德是治疗儿童烧伤后肥厚性瘢痕的一种有效且安全的方法。这种方法能显著减轻疼痛和瘙痒,使医生和患者的满意度都很高,值得临床推荐。

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