摘要
目的应用高频超声评价超脉冲CO_(2)点阵激光联合硅酮贴治疗增生性瘢痕的临床效果。方法选择2017年1月至2019年5月的58例烧烫伤后增生性瘢痕的患者,男24例,女34例,年龄13~60岁,平均(30.6±7.8)岁。每处瘢痕予超脉冲CO_(2)点阵激光治疗4次,每次激光创面完全愈合后,局部外用硅凝胶贴至下次激光治疗,激光治疗间隔为12周,总治疗时间1年。治疗前和末次治疗完成后3个月,拍摄瘢痕数码照片进行视觉模拟量表评估,并使用高频超声对瘢痕进行检测,对治疗前后的瘢痕厚度超声数据和超声回声密度进行统计,进行配对t检验。结果治疗完成后,瘢痕厚度的高频超声测量值较治疗前均有不同程度的下降,其结果差异有统计学意义(P<0.001)。各个瘢痕部位回声密度治疗后均有不同程度的上升。背部、颈部、上肢、下肢瘢痕患者治疗前后回声密度数值相比,差异均有统计学意义(P<0.001)。额部瘢痕患者治疗前后回声密度数值相比差异有统计学意义(P<0.05)。VAS评分瘢痕改善率98.3%,患者满意度96.6%。结论高频超声可精确评价增生性瘢痕的治疗效果,可作为一种理想的工具来评估增生性瘢痕的光电治疗反应。
Objective To evaluate improvements of thickness of hypertrophic scar treated by ultrapulse fractional carbon dioxide laser combined with silicone patch by high-frequency ultrasound.Methods From Jan 2017 to May 2019,59 patients with hypertrophic scars after burns admitted to our hospital were recruited in this study(24 males and 34 females),aged 13~60 years,with an average age of(30.6±7.8)years.Each scar was treated with UFCL for 4 times.After wound was completely healed,silicon gel was applied locally and externally until the next laser treatment time.The interval between treatment was 12 weeks,and total treatment lasted 1 year.Before treatment and 3 months after completion of last treatment,digital photos of scars were taken for visual analog scale evaluation,and high-frequency ultrasound was used to detect scars.The ultrasound data of scar thickness and ultrasound echo density before and after treatment were statistically analyzed by pairedt-test.Results After treatment,measured value of scar thickness by high-frequency ultrasound decreased to some extent compared with that before treatment with statistically significant difference(P<0.001).The measured echo density of scar was higher than that before treatment.The echo density values of patients with scar on back,neck,upper limb and lower limb before and after treatment were significantly different(P<0.001).The echo density of patients with frontal scar before and after treatment was statistically different(P<0.05).The scar improvement rate of VAS score was 98.3%,and patient satisfaction was 96.6%.Conclusion High-frequency ultrasound could accurately evaluate therapeutic effect of hypertrophic scar and be used as an ideal tool to evaluate the therapeutic response of hypertrophic scar.
作者
王珏
高全文
杨锴
刘岩
杨巧
陈园婧
李嘉颐
武江
Wang Jue;Gao Quanwen(Yang Kai Department of Medical Cosmetology,Beijing Jishuitan Hospital,Beijing 102208;Senior Department of Burn and Plastic Surgery,the Fourth Medical Center of PLA General Hospital,Beijing 100048,China)
出处
《四川医学》
CAS
2022年第11期1124-1128,共5页
Sichuan Medical Journal
关键词
高频超声
超脉冲CO_(2)点阵激光
增生性瘢痕
超声回声密度
high-frequency ultrasound
ultrapulsed fractional CO_(2) laser
hypertrophic scar
high-frequency ultrasound intensity
作者简介
通信作者:武江,E-mail:pvmaxwell0819@126.com。
