李大鹏

[摘要]目的：本研究旨在探讨美容缝合联合剥脱性二氧化碳点阵激光对于颌面部增生性瘢痕的临床效果。方法：本研究选取2015年1月至2019年1月在笔者科室接受治疗的158例颌面部增生性瘢痕患者。所有患者均接受了美容缝合联合剥脱性二氧化碳点阵激光治疗，在治疗前和治疗后6个月采用温哥华瘢痕量表（Vancouver scar scale，VSS）、北卡罗来纳大学（the University of North Carolina，UNC）瘢痕量表、患者满意度来评估临床效果。结果：治疗前VSS评分为（9.35±1.82）分高于治疗后6个月的（3.12±1.04）分，治疗前UNC瘢痕量表评分为（8.03±1.45）分高于治疗后6个月的（1.62±0.72）分，差异均有统计学意义（P<0.05）。患者的总体满意率为100%，所有患者均未发生长期并发症。结论：美容缝合联合剥脱性二氧化碳点阵激光能够有效地治疗颌面部增生性瘢痕，效果满意。

[关键词]增生性瘢痕;剥脱性二氧化碳点阵激光;美容缝合;瘢痕量表;满意度

[中图分类号]R619+.6    [文献标志码]A    [文章编号]1008-6455（2020）08-0085-03

Effect of Cosmetic Suture Combined with Exfoliative CO2 Dot-matrix Laser in the Treatment of Maxillofacial Hypertrophic Scar

LI Da-peng

（Department of Medical Cosmetology，Handan Central Hospital，Handan 056008，Hebei，China）

Abstract： Objective  The present study was to investigate the clinical effect of cosmetic suture combined with exfoliative CO2 dot-matrix laser on maxillofacial hypertrophic scar. Methods  The present study included a total of 158 patients with maxillofacial hypertrophic scar who were treated in our department from January 2015 to January 2019. All patients underwent cosmetic suture combined with exfoliative CO2 dot-matrix laser. The Vancouver scar scale （VSS）， the University of North Carolina （UNC） scar scale， and patients，satisfaction survey were used to assess clinical outcomes before and 6 months after treatment. Results  The score of VSS before treatment was （9.35±1.82） higher than that of 6 months after treatment （3.12±1.04）， the difference was statistically significant（P<0.05）. The score of UNCC scar scale before treatment was （8.03±1.45） which was higher than that of 6 months after treatment （1.62±0.72， P<0.05）. The overall satisfaction rate was 100%. No long-term complications occurred in all patients. Conclusion  Cosmetic suture combined with exfoliative CO2 dot-matrix laser can effectively treat maxillofacial hypertrophic scar.

Key words： hypertrophic scar; exfoliative CO2 dot-matrix laser; cosmetic suture; scar scale; satisfaction

增生性瘢痕是皮膚中的一种常见疾病，通常会出现在Ⅱ度或Ⅲ度烧伤、外科手术后延迟愈合的伤口、其他情况造成的手术伤口张力过大等。临床表现为瘢痕组织明显高于周围皮肤，呈深红色或紫色，有时伴有局部灼痛和瘙痒。这些表现可能持续数月甚至数年[1]。增生性瘢痕的传统治疗方法包括局部注射皮质类固醇激素、手术切除、加压包扎等。随着激光技术的发展，各种激光在增生性瘢痕中的作用已引起皮肤科医生越来越多的关注[2-3]。近年来，剥脱性二氧化碳点阵激光已被证明是治疗皱纹和瘢痕的最有效的医疗设备之一[4-7]。自2015年以来，笔者科室采用美容缝合联合剥脱性二氧化碳点阵激光治疗颌面部增生性瘢痕，取得了较好的效果，现报道如下。……