[摘要]目的：探究曲安奈德注射联合点阵CO2激光治疗面部烧伤后增生性瘢痕（Hypertrophic scar，HS）的临床效果。方法：对2022年1月-2023年12月笔者医院收治的98例面部烧伤后HS患者的临床资料进行回顾性分析，按修复方式的不同分成激光组（45例）和联合组（53例）。激光组应用点阵CO2激光修复，联合组应用曲安奈德注射联合点阵CO2激光修复，时长为6个月。比较两组疗效、HS相关指标、血清炎性因子、不良反应发生率和面部美学效果的差异。结果：治疗后，联合组总有效率高于激光组（96.23% vs.80.00%，P＜0.05）；两组改良温哥华瘢痕量表（mVSS）柔软度、厚度、血管分布、色泽、疼痛、瘙痒各维度评分、HS厚度及血流灌注量均低于同组治疗前，且联合组均低于激光组（P＜0.05）；两组P物质（SP）、白细胞介素（IL）-6、肿瘤坏死因子（TNF）-α、转化生长因子（TGF）-β1水平均低于同组治疗前，且联合组低于激光组（P＜0.05）；治疗期间，两组不良反应发生率差异无统计学意义（P＞0.05）；联合组面部美学效果各维度评分和总分均高于激光组（P＜0.05）。结论：曲安奈德注射联合点阵CO2激光对面部烧伤后HS患者的疗效显著，能有效减轻炎症反应，改善HS情况，促进HS消退，提高美学效果，且安全性高。

[关键词]面部烧伤；增生性瘢痕；点阵CO2激光；曲安奈德注射；修复；美学效果

[中图分类号]R619.6" " [文献标志码]A" " [文章编号]1008-6455（2025）06-0096-05

Repair Effect of Triamcinolone Injection Combined with" Fractional CO2 Laser on Hypertrophic Scar after Facial Burn

LIU Yanbing， ZHU Xiumei， MU Shengzhi

（ Department of Burns Plastic Medicine amp; Cosmetic Surgery， Shaanxi Provincial People's Hospital， Xi'an 710068，

Shaanxi， China ）

Abstract： Objective" To explore the repair effect of triamcinolone injection combined with fractional CO2 laser on hypertrophic scar （HS） after facial burn. Methods" The clinical data of 98 patients with HS after facial burn in the hospital were retrospectively analyzed between January 2022 and December 2023. According to different repair methods， patients were divided into laser group （45 cases， fractional CO2 laser） and combination group （53 cases， triamcinolone injection combined with fractional CO2 laser）. All were intervened for 6 months. The curative effect， HS-related indexes， serum inflammatory factors， incidence of adverse reactions and facial aesthetic effect were compared between the two groups. Results" After treatment， total response rate of combination group was higher than that of laser group （96.23% vs. 80.00%， P＜0.05）. After treatment， scores of modified Vancouver scar scale （mVSS， including softness， thickness， vessel distribution， color， pain and pruritus dimensions）， HS thickness and blood perfusion volume were decreased in both groups， which were lower in combination group than laser group （P＜0.05）. After treatment， levels of substance P （SP）， interleukin （IL）-6， tumor necrosis factor （TNF）-α and transforming growth factor （TGF）-β1 were decreased in both groups， which were lower in combination group than laser group （P＜0.05）. During treatment， the difference in the incidence of adverse reactions between the two groups was not statistically significant （P＞0.05）. The scores and total score of facial aesthetic effect in combination group were higher than those in laser group （P＜0.05）. Conclusion" Curative effect of triamcinolone injection combined with fractional CO2 laser is significant in patients with HS after facial burn， which can effectively relieve inflammatory response， improve HS， promote HS regression and improve aesthetic effect， with high safety.

Key words： facial burn; hypertrophic scar; fractional CO2 laser; triamcinolone injection; repair; curative effect; aesthetic effect

面部烧伤是一种在化学物质、热力、电流、放射线等因素作用下头面部皮肤、黏膜乃至其下肌肉、骨骼发生损伤的外科疾病[1-2]，轻者采用冷敷、烧伤膏药物、抗生素治疗即可痊愈[3]，重度烧伤者以植皮手术可显著修复创面[4]，但面部……