美容缝合后不同时间激光序列治疗的临床效果观察

宋雨健 郭晓莉

[摘要]目的探討美容缝合后不同时间行激光序列治疗的临床效果及安全性。方法选取2016年8月至2019年8月武装警察部队四川省总队医院皮肤科收治的200例面部创伤后美容缝合的患者作为研究对象，随机分为 A、B 两组，每组各100例。分别于术后第2周和第6周开始接受激光序列治疗。收集两组患者每次治疗后的温哥华瘢痕量表评分（VSS）进行对比分析，并比较患者满意度、炎性细胞因子水平和不良反应发生情况。结果治疗前，两组患者的 VSS 评分比较差异无统计学意义（ P >0.05）。治疗后各时间点比较， A 组患者创口 VSS 评分均低于 B 组患者，差异有统计学意义（ P <0.05）。A 组患者治疗总满意度为98.00%，高于 B 组的91.00%，差异有统计学意义（ P <0.05）。两组患者不良反应发生率比较差异无统计学意义（ P >0.05）。治疗后， A 组患者的白细胞介素-8（IL-8）和肿瘤坏死因子-α（TNF-α）水平均低于 B 组，差异有统计学意义（ P <0.05）。结论面部创伤患者接受整形美容清创缝合技术治疗后，可尽早进行激光序列治疗。该治疗不仅不会影响伤口的正常愈合，还有助于预防瘢痕的产生与发展，降低外周炎性细胞因子水平，提升患者对治疗效果的满意度，有较好的安全性，具有一定临床价值。

[关键词]美容缝合; CO2点阵激光;脉冲染料;瘢痕

[中图分类号] R622 [文献标识码] A  [文章编号]2095-0616（2021）22-0019-04

Observation on the clinical effect of laser sequence therapy at different times after cosmetic suture

SONG  Yujian   GUO  Xiaoli

Department of Dermatology， Sichuan Provincial Corps Hospital of Armed Police Forces， Sichuan， Leshan 614000，China

[Abstract] Objective To explore the clinical effect and safety of laser sequence therapy at different times after cosmetic suture. Methods A total of 200 patients undergoing facial post-traumatic cosmetic suture admitted to the Department of Dermatology of Sichuan Provincial Corps Hospital of Armed Police Forces from August 2016 to August 2019 were selected as the research objects. They were randomly divided into groups A and B， with 100 cases in each group. The laser sequence therapy was conducted on the 2nd and 6th weeks after the operation， respectively. The Vancouver Scar Scale （VSS） score of the two groups of patients after each treatment was collected for comparative analysis， and patients' satisfaction， inflammatory cytokine levels and adverse reactions were compared. Results There was no statistically significant difference in VSS score between the two groups before treatment （P >0.05）. The VSS score of wound in group A was lower than that in group B at each time point after treatment， with statistically significant difference （P <0.05）. The total satisfaction rate of patients in group A was 98.00% higher than that of 91.00% in group B， with statistically significant difference （P <0.05）. There was no statistically significant difference in the incidence of adverse reactions between the two groups （P >0.05）. After treatment， the levels of interleukin-8（IL-8） and tumor necrosis factor-α（TNF-α） in group A were significantly lower than those in group B， with statistically significant differences （P <0.05）. Conclusion After plastic surgery， cosmetic debridement and suture， the patients with facial trauma can be treated with laser sequence as soon as possible. This treatment not only does not affect the normal wound healing， but also helps to prevent the emergence and development of scar， reduce the level of peripheral inflammatory cytokines， improve patients' satisfaction with the treatment effect， with higher safety， and it has a certain clinical value.

[Key words] Cosmetic suture; CO2 lattice laser; Pulsed dye; Scar

随时代发展，人们对美观的重视程度越来越高，尤其是对发生面部创伤的患者而言，如何在美容缝合后有效减少瘢痕组织形成，是当前相关领域的研究热点和难点[1]。有报道称，595 nm 脉冲染料能够有效穿透瘢痕组织，抑制其中的胶原沉积和血管增生，使瘢痕提前进入成熟期[2]。而 CO2点阵激光治疗则有助于瘢痕内胶原排列由无序向有序转变[3]。有学者研究认为，两种激光治疗进行序列应用，效果优于单一激光治疗。但对于最佳治疗时机的选择，目前尚无定论。多数观点认为，伤口愈合后2～3个月是干预的最佳时机，避免了过早激光治疗对伤口正常愈合的影响[4]。故本……