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《中国美容医学》[ISSN:1008-6445/CN:61-1347/R]

卷:

期数:

2022年10期

页码:

82-86

栏目:

出版日期:

2022-10-10

文章信息/Info

Title:

The VSS Score of Ultra-pulse CO₂ Laser Combined with Triamcinolone Acetonide Injection on Patients with Auricular Keloids and the Effect of Recurrence About It

文章编号:

1008-6455（2022）10-0082-04

作者:

李波蓬; 刘 艳; 蔡 洁; 丁 锋; 刘雪萍

(武汉市汉口医院耳鼻咽喉科 湖北 武汉 430012)

Author(s):

LI Bopeng; LIU Yan; CAI Jie; DING Feng; LIU Xueping

(Department of Otolaryngology,Wuhan Hankou Hospital,Wuhan 430012,Hubei,China)

关键词:

耳廓瘢痕疙瘩; 超脉冲CO₂激光; 曲安奈德注射; 瘢痕严重程度; 并发症; 复发

Keywords:

auricular keloid;  ultra-pulse CO₂ laser;  triamcinolone acetonide injection;  scar severity;  complications;  recurrence

分类号:

R619+ .6

文献标志码:

A

摘要:

目的：从临床疗效、安全性、复发情况等多方面探讨超脉冲CO2激光联合曲安奈德注射治疗耳廓瘢痕疙瘩的综合效 果。方法：选取2016年10月-2019年10月笔者医院128例耳廓瘢痕疙瘩患者，采用Sawada量表进行分级，随机分为联合组（超 脉冲CO₂激光配合曲安奈德注射治疗，n=43）、激光组（超脉冲CO2激光，n=43）、药物组（曲安奈德注射，n=42）。对比3 组临床疗效、温哥华瘢痕量表（VSS）评分、并发症发生率及累计复发率，并对比不同病情程度患者疗效。结果：三组整 体疗效与安全性：联合组、激光组总有效率分别为90.70%（39/43）、76.74%（33/43），均高于药物组59.52%（25/42） （P＜0.05），3组并发症发生率无明显差异（P＞0.05）。不同病情程度临床疗效：轻度、重度患者中，3组临床疗效差异 无统计学意义（P＞0.05），中度患者中，联合组、激光组总有效率分别为89.47%（17/19）、78.26%（18/23），均高于药物 组45.45%（10/22，P＜0.05）；疗程结束后、治疗后3个月，三组VSS量表各项评分及总分均为联合组＜激光组＜药物组，差异 有统计学意义（P＜0.05）；随访12个月，联合组累及复发率为7.14%（3/42），低于药物组27.50%（11/40，P＜0.05），但与 激光组17.07%（7/41）比较无明显差异（P＞0.05）。结论：超脉冲CO₂激光配合曲安奈德注射治疗耳廓瘢痕疙瘩的临床疗效显 著，可有效促进患者瘢痕减退，同时减少复发，是安全可靠的临床治疗方案，尤其对于中、重度患者，联合治疗十分必要。

Abstract:

Objective To explore the comprehensive effects of ultra-pulse CO₂ laser combined with triamcinolone acetonide injection in the treatment of auricular keloids from various aspects such as clinical effi cacy, safety, and recurrence. Methods A total of 128 patients with auricular keloids in our hospital from October 2016 to October 2019 were selected and graded using the Sawada scale. They were randomly divided into combination group (ultra-pulse CO₂ laser combined with triamcinolone acetonide injection therapy, n=43), laser group (ultra-pulse CO₂ laser, n=43), drug group (triamcinolone acetonide injection, n=42).The clinical efficacy, Vancouver scar scale (VSS) score, complication rate and cumulative recurrence rate of the three groups were compared, and the efficacy of patients with different degrees of disease was compared. Results the total effective rate of the combined group and the laser group were 90.70% (39/43) and 76.74% (33/43) respectively, which were higher than the drug group 59.52% (25/42, P＜0.05), there was no significant difference in the incidence of complications between the 3 groups (P＞0.05). In mild and severe patients, the clinical efficacy of the three groups was not statistically different (P＞0.05). In moderate patients, the total effective rate of the combination group and the laser group was 89.47% (17 /19), 78.26% (18/23), all higher than the drug group 45.45% (10/22, P＜0.05). After the course of treatment and 3 months after treatment, the scores and total scores of the three groups of VSS scales were all in the combined group＜laser group＜drug group, and the difference was statistically significant (P＜0.05). After 12 months of follow-up, the involved recurrence rate in the combined group was 7.14% (3/42), which was lower than the drug group by 27.50% (11/40, P＜0.05), but compared with the laser group by 17.07% (7/41) There is no signifi cant difference in comparison(P＞0.05). Conclusion Ultra-pulse CO₂ laser combined with triamcinolone acetonide injection has a significant clinical effect on auricular keloids. It can eff ectively promote the reduction of scars in patients and reduce recurrence. It is a safe and reliable clinical treatment plan, especially for moderate and severe patients, combined therapy is very necessary.

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更新日期/Last Update: 2022-10-20