宋秋伦 洪伟 杨雄波

[摘要]目的：探討点阵CO2超脉冲激光联合重组牛碱性成纤维细胞生长因子（rb-bFGF）治疗萎缩性瘢痕对相关指标的影响分析。方法：选取2017年2月-2019年3月笔者医院收治的104例萎缩性瘢痕患者为研究对象，采用随机数字表法将其分为对照组（52例）和观察组（52例）。对照组：采用CO2点阵超脉冲激光+生理盐水湿敷;观察组：采用CO2点阵超脉冲激光+rb-bFGF湿敷。观察比较两组患者的临床疗效、痤疮瘢痕权重（ECCA）得分、结痂时间、疼痛持续时间、视觉模拟评分（VAS）以及术后满意度。结果：观察组总有效率为92.31%，显著高于对照组的75.00%（P<0.05）;治疗后，两组痤疮瘢痕权重（ECCA）得分均低于治疗前，且观察组显著低于对照组（P<0.05）;观察组伤口愈合时间、术后疼痛时间及视觉模拟评分（VAS）均显著低于对照组（P<0.05）;观察组总满意率为92.31%，显著高于对照组的69.23%（P<0.05）。结论：在点阵CO2超脉冲激光治疗萎缩性瘢痕的基础上联合外用rb-bFGF凝胶，可显著降低患者ECCA、VAS评分，缩短患者伤口愈合时间及术后疼痛时间，从而提高患者临床疗效及满意率。

[关键词]二氧化碳超脉冲激光;重组牛碱性成纤维细胞生长因子;萎缩性瘢痕;视觉模拟评分;痤疮瘢痕权重评分

[中图分类号]R619+.6    [文献标志码]A    [文章编号]1008-6455（2021）01-0069-03

Analysis of Related Indexes of Acupoint CO2 Ultrapulse Laser Combined with rb-bFGF in the Treatment of Atrophic Scar

SONG Qiu-lun， HONG Wei， YANG Xiong-bo

（Department of Dermatology，Chongqing Three Gorges Central Hospital，Chongqing 404100， China）

Abstract： Objective  To investigate the related indexes of dot matrix CO2 ultrapulse laser combined with recombinant bovine basic fibroblast growth factor （rb-bFGF） in the treatment of atrophic scar. Methods  A total of 104 patients with atrophic scars admitted to our hospital between February 2017 and March 2019 were selected and divided into the control group （52 cases） and the observation group （52 cases） by random number table method. The control group was treated with CO2 dot matrix ultrapulse laser + saline wet solution， the observation group was treated with CO2 dot matrix ultra pulse laser + rb-bFGF wet compress. The clinical efficacy， acne scar weight （ECCA） weight score， crusting time， pain duration， visual analog scale （VAS）， and postoperative satisfaction were compared between the two groups. Results  The total effective number in the observation group was 48 cases， 92.31% of total efficiency， the research group was obviously higher than that in the control group， with 39 cases and the total effective rate of 75.00% （P<0.05）. The scores of ECCA weight in the observation group and in the control group were significantly lower than those before treatment （P<0.05）. The scores of ECCA weight in the research group were obviously lower than the scores of ECCA weight in the comparison group （P<0.05）. The observation time， pain duration and score of VAS in the observation group were obviously lower than the score of VAS in the comparison group （P<0.05）.The total satisfaction in the observation group was 48 cases， the satisfaction rate was 92.31%， the total satisfactory number in the control group was 36 cases， and the satisfaction rate was 69.23%. The satisfaction rate in the observation group was significantly higher than that in the control group， and the difference was statistically significant （P<0.05）. Conclusion  Combined with the use of lattice CO2 ultra-pulse laser to treat atrophic scars， combined with external application of rb-bFGF gel can significantly reduce the ECCA and VAS scores of patients， shorten the wound healing time and postoperative pain time， thereby improving the clinical efficacy and satisfaction rate

Key words： carbon dioxide ultra-pulse lightning; recombinant bovine basic fibroblast growth factor; atrophic scar; visual analogue score; schelled，evaluation clinique descicatrices d，acne

萎缩性瘢痕是指由于神经、血管的衰退与胶原纤维的形成，而导致患者表皮出现破溃、感染或溃疡的一种疾病，严重影响患者面容美观。临床多选择手术治疗萎缩性瘢痕[1-2]，其中点阵超脉冲CO2激光作用于萎缩性瘢痕患者面部皮肤组织后，可刺激患者皮肤胶原蛋白快速增生，加快面部皮肤新陈代谢，使得皮膚伤口愈合速度加快，对萎缩性瘢痕疗效较佳，但该治疗技术具有一定后遗症，影响患者预后[3]。有关研究指出[4]，重组牛碱性成纤维细胞生长因子（Recombinant human basic fibroblast growth factor，rb-bFGF）可通过促进蛋白质的生成，加快萎缩性瘢痕患者面部皮肤组织的改善，且对人体产生的副作用小。故本研究致力于通过探讨点阵CO2超脉冲激光联合rb-bFGF治疗萎缩性瘢痕对患者的影响，旨在为临床治疗萎缩性瘢痕提高有效科学依据。……