[摘要]目的：探究超脉冲点阵CO2激光联合强脉冲光（Intense pulsed laser，IPL）改善增生性瘢痕（Hypertrophic scar，HS）颜色及瘙痒的效果。方法：将2021年6月-2023年6月笔者医院收治的96例HS患者按就诊次序随机分为两组，每组48例，对照组给予超脉冲点阵CO2激光治疗，观察组在对照组基础上联合IPL治疗，比较两组临床疗效以及治疗前后相关指标改变、美学效果满意度及不良反应发生情况。结果：观察组临床总有效率更高（P＜0.05）。治疗前两组各项指标对比差异无统计学意义（P＞0.05）；治疗后3个月，两组皮肤屏障功能、瘢痕血流灌注量、症状严重程度评分均有明显改善，其中观察组改善更明显（P＜0.05）。观察组美学效果满意度（93.75%）较对照组（77.08%）高，且观察组（6.25%）总不良反应总发生率低于对照组（20.83%）（P＜0.05）。结论：超脉冲点阵CO2激光联合IPL治疗HS疗效显著，可明显改善患者皮肤屏障功能，减轻相关症状，提高皮肤美观度，并减少不良反应的发生。

[关键词]增生性瘢痕；强脉冲光；超脉冲点阵CO2激光

[中图分类号]R758.73" " [文献标志码]A" " [文章编号]1008-6455（2025）07-0111-04

Observation on the Effect of Super Pulsed Fractional CO2 Laser Combined with Intense Pulsed Laser in Hyperplastic Scars

MU KunYu1，2， CHEN Xingyang2， KONG Yusu3

（ 1. Department of Surgery， Clinical Medical College， Guizhou Medical University， Guiyang 550002， Guizhou， China; 2. Department of Plastic and Burn Surgery， First People's Hospital of Guiyang City， Guiyang 550001， Guizhou， China;

3. Department of Burn and Plastic Surgery， Affiliated Hospital of Guizhou Medical University， Guiyang 550002， Guizhou， China）

Abstract： Objective" To investigate the effect of ultrapulsed fractional CO2 laser combined with Intense pulsed laser （IPL） in improving the colour and itching of hyperplastic scar （HS）. Methods" 96 cases of HS patients admitted to the hospital from June 2021 to June 2023 were randomly divided into two groups， 48 cases/group， the control group was given super pulsed fractional CO2 laser treatment， and the observation group was combined with IPL treatment on the basis of the control group， comparing the clinical efficacy of the two groups， as well as the changes in relevant indexes before and after the treatment， satisfaction with the aesthetic effect， and the occurrence of adverse reactions. Results" The total clinical effective rate of the observation group was higher （P＜0.05）. There was no difference in the comparison of the two indexes before treatment （P＞0.05）; 3 months after treatment， the skin barrier function， scar blood perfusion volume， and symptom severity scores of the two groups improved significantly， in which the observation group improved more significantly （P＜0.05）. The aesthetic satisfaction rate in the observation group （93.75%） was higher than that in the control group （77.08%）， and the overall incidence of adverse reactions in the observation group （6.25%） was lower than that in the control group （20.83%） （P＜0.05）. Conclusion" Ultra-pulsed fractional CO2 laser combined with IPL has significant efficacy in the treatment of HS， which can significantly improve the skin barrier function of patients， reduce the related symptoms， improve skin aesthetics， and is safe.

Key words： hypertrophic scar; intense pulsed laser; ultrapulsed fractional CO2 laser

在手术、烧烫伤和感染后的恢复过程中，增生性瘢痕（Hypertrophic scar，HS）是一种常见并发症，其特点是皮肤纤维结缔组织过度生长，导致皮肤表面出现隆起，且形状不规则，影响外观，并伴有灼痛和瘙痒感，严重影响患者身心健康及生活质量[1]。目前临床治疗HS的常见手段有局部封闭疗法和外科手术，但均存在一定局限性[2]。光疗法的进步在近年为HS的治疗带来了新的治疗策略，因其疗效显著、操作简单和副作用小而受到越来越多的重视。强脉冲光（Intense pulsed laser，IPL）和超脉冲点阵CO2激光因其独特的优势，在治疗多种皮肤问题中展现出显著疗效，也逐渐成为改善增生性瘢痕的热点研究方向。……