蒋亚楠 赵德梅 高宇 葛华强 倪健 谭谦

[摘要]目的：观察窄谱强脉冲光治疗早期颜面部创伤性瘢痕的有效性和安全性。方法：2017年1月-2019年6月，对42例（54处）早期颜面部创伤性瘢痕患者采用窄谱强脉冲光进行治疗。每次治疗间隔4～6周。治疗结束后3个月对瘢痕进行疗效评价和不良反应评价。结果：瘢痕治疗显效22处，有效27处，无效5处，总有效率为90.74%。不良反应包括皮肤红斑、水肿、水疱和短期色素减退及色素沉着。结论：窄谱强脉冲光治疗早期颜面部创伤性瘢痕疗效确切，安全性高。

[关键词]瘢痕;窄谱强脉冲光;颜面部;个性化治疗;疗效;不良反应

[中图分类号]R619+.6    [文献标志码]A    [文章编号]1008-6455（2021）05-0035-03

Evaluation of Narrow-spectrum Intense Pulsed Light in the Treatment of Early Facial Traumatic Scar

JIANG Ya-nan，ZHAO De-mei，GAO Yu，GE Hua-qiang，NI Jian，TAN Qian

（Department of Burns and Plastic Surgery，Nanjing Drum Tower Hospital，the Affiliated Hospital of Nanjing University Medical School，Nanjing 210008，Jiangsu，China）

Abstract： Objective  To evaluate the effectiveness and safety of narrow-spectrum intense pulsed light for the treatment of early facial traumatic scar. Methods  From January 2017 to June 2019， 42 cases with early facial traumatic scar （54 places）were treated with narrow-spectrum intense pulsed light （DPL， 500-600nm）. The treatment interval was 4-6 weeks. Three months after treatment， efficacy and adverse effects were evaluated and analyzed. Results  Twenty-two scars had significant improvement， 27 scars had moderate improvement， and 5 scars had no improvement. The effective rate was 90.74%. Adverse reactions included skin erythema， edema， blisters and short-term hypopigmentation and pigmentation. Conclusion  The narrow-spectrum intense pulsed light can be considered as an effective and safe method for the treatment of early facial traumatic scar.

Key words： scar; narrow-spectrum intense pulsed light; facial; individualized treatment; curative effect; adverse reactions

各種创伤（烧伤、外伤、手术）引起的颜面部瘢痕不仅影响局部外观和功能，还可伴有瘙痒、疼痛、感觉异常等症状，严重者易导致心理问题，影响生活质量[1]。近年来，现代光电技术发展迅速，已成为创伤性瘢痕防治的主要手段之一[2]。创伤性瘢痕早期常呈现潮红或紫红色外观，因丰富的血供支撑了瘢痕内成纤维细胞的高代谢，易诱发瘢痕增生[3-4]。因此，针对瘢痕内血管的治疗是瘢痕有效防治的关键。窄谱强脉冲光通过先进技术将激光的精准性及传统强脉冲光的无创特点相结合，用于治疗皮肤浅表血管性疾病已有大量报道[5]。但应用于早期颜面部创伤性瘢痕的防治尚无报道。笔者医院应用窄谱强脉冲光对早期颜面部创伤性瘢痕进行治疗，获得了较满意的疗效，现报道如下。

1  资料和方法