卢会秀 曹海育 李建英 孙静

[摘要]目的：分析Cynergy双波长脉冲染料激光联合局部封闭治疗病理性瘢痕的療效。方法：选择2018年1月-2019年7月笔者科室治疗的100例病理性瘢痕患者为研究对象，随机分为对照组和观察组，每组50例。观察组采用局部封闭治疗联合Cynergy双波长脉冲染料激光进行治疗，对照组采用局部封闭治疗，两组均治疗4个月。比较两组治疗4个月后的疗效，比较两组治疗前后瘢痕改善情况、瘢痕症状变化及治疗期间不良反应发生情况。结果：治疗4个月后，观察组总有效率高于对照组（P<0.05）。与治疗前比较，治疗4个月后两组瘢痕色泽、血管分布、厚度、柔软度和温哥华瘢痕量表（VSS）总分、视觉模拟评分（VAS）、瘙痒评分均显著下降，且观察组均显著低于对照组（P<0.05）。治疗期间，观察组不良反应发生率为22.00%，与对照组（18.00%）比较，差异无统计学意义（P>0.05）。结论：采用Cynergy双波长脉冲染料激光联合局部封闭治疗可有效改善病理性瘢痕患者瘢痕状态和症状，疗效较好，同时安全性高。

[关键词]病理性瘢痕;Cynergy双波长脉冲染料激光;局部封闭治疗;瘢痕状态;粗糙程度

[中图分类号]R619+.6    [文献标志码]A    [文章编号]1008-6455（2021）06-0079-04

Therapeutic Effect of Cynergy Dual-wavelength Pulsed Dye Laser Combined with Local Sealing in the Treatment of Pathological Scar

LU Hui-xiu， CAO Hai-yu， LI Jian-ying， SUN Jing

（Department of Dermatology，Shijiazhuang People's Hospital， Shijiazhuang 050000，Hebei，China）

Abstract：Objective To analyze the effect of Cynergy dual-wavelength pulsed dye laser combined with local blocking treatment on scar status of patients with pathological scar. Methods  Between January 2018 and July 2019， 100 patients with pathological scar in in outpatient department of dermatology of our hospital were taken as research objects， and were randomly divided into the control group and the observation group by random number table method， with 50 cases in each group. The control group was treated with local blocking， and the observation group was treated with Cynergy dual-wavelength pulsed dye laser on the basis of the control group. Both groups were treated for 4 months. The curative effect of the two groups was compared after 4 months of treatment， the improvement of scar and the change of scar symptoms were compared before and after 4 months of treatment， and the occurrence of adverse reactions was compared between the two groups during treatment. Results  After 4 months of treatment，the total effective rate of the observation group was significantly higher than the control group （70.00%， P<0.05）. Compared with before treatment， the color， blood vessel distribution， thickness， softness， total score of Vancouver scar scale （VSS）， visual analogue scale （VAS） of the two groups decreased significantly after 4 months of treatment， and the control group was significantly higher than the observation group （P<0.05）. During the treatment， the incidence of adverse reactions in the observation group was 22.00%， which was not significantly different from that in the control group （118.00%， P>0.05）. Conclusion  Cynergy dual-wavelength pulsed dye laser combined with local blocking treatment could effectively improve the scar state and symptoms of patients with pathological scar， with good curative effect and high safety.

Key words：pathological scar; cynergy dual-wavelength pulsed dye laser; local block treatment; scar state; roughness

病理性瘢痕是组织损伤后引起的皮肤外观和组织病理学不规则改变的统称，主要包括瘢痕疙瘩和增生性瘢痕，其不仅影响患者的外观，还可导致严重的功能障碍，给患者的身心带来极大伤害[1]。目前，治疗病理性瘢痕的方法很多，局部封闭治疗是主要的治疗方法之一，具有经济、有效的优点，但单纯使用局部封闭治疗时的复发率较高，且长期应用可能引起内分泌紊乱，疗效欠佳[2]。Cynergy双波长脉冲染料激光是近年来治疗皮肤性疾病的主要手段之一，与其他类型激光相比，其具有创伤小、副作用小的优点，同时可有效改善局部皮肤的血管增生、色素沉着等问题[3-4]。……