中华烧伤杂志
中華燒傷雜誌
중화소상잡지
16
2015年
3期
164-167
,共4页
雷晋%郝振明%禹丽峰%段鹏%孟艳斌
雷晉%郝振明%禹麗峰%段鵬%孟豔斌
뢰진%학진명%우려봉%단붕%맹염빈
烧伤%瘢痕%激光疗法%中草药
燒傷%瘢痕%激光療法%中草藥
소상%반흔%격광요법%중초약
Burns%Cicatrix%Laser therapy%Drugs,Chinese herbal
目的 探讨超脉冲二氧化碳点阵激光结合中药复春散治疗烧伤后增生性瘢痕的临床效果. 方法 2012年2月-2014年6月,选择笔者单位收治的63例烧伤后增生性瘢痕患者,采用超脉冲二氧化碳点阵激光结合中药复春散治疗.根据瘢痕形成时间,将患者分为早期组、中期组、晚期组.早期组为瘢痕形成3周～3个月患者,共35例;中期组为瘢痕形成时间大于3个月且小于或等于6个月患者,共25例;晚期组为3～15年陈旧性瘢痕患者,共3例.统计各组患者的激光治疗次数;数字评价量表(NRS)评定3组患者治疗前及治疗1、2、3次后的瘢痕疼痛强度;温哥华瘢痕评定量表评定瘢痕情况,比较早期组、中期组患者在治疗前及治疗1、3、5次后的分值,晚期组患者只观察、不评分;治疗前及治疗3、5次后,拍摄3组患者治疗区域瘢痕照片评价疗效.对数据行t检验. 结果 早期组患者治疗(4.8±1.1)次;中期组(7.7±2.1)次;晚期组中2例患者治疗5次后终止治疗,1例治疗12次.治疗1次后,早期组和中期组患者疼痛减轻明显,NRS评分1～4分者由5例增至38例;治疗2、3次后,1～4分者增加幅度不大.治疗前和治疗1次后,早期组、中期组患者瘢痕情况评分相近(t值分别为0.641、0.082、P值均大于0.05);治疗3、5次后,早期组患者的瘢痕情况评分分别为(9.2±0.8)、(7.0±1.1)分,明显低于中期组的(9.7±1.0)、(8.2±1.0)分(t值分别为-1.993、-4.433,P＜0.05或P＜0.01).治疗3次后,早期组、中期组患者总有效率分别为88.6％ (31/35)、72.0％(18/25);治疗5次后,早期组、中期组患者总有效率分别为100.0％(35/35)、96.0％(24/25);治疗5次后晚期组3例患者效果不明显. 结论 烧伤后增生性瘢痕早期应用超脉冲二氧化碳点阵激光结合中药复春散治疗,效果明确.
目的 探討超脈遲二氧化碳點陣激光結閤中藥複春散治療燒傷後增生性瘢痕的臨床效果. 方法 2012年2月-2014年6月,選擇筆者單位收治的63例燒傷後增生性瘢痕患者,採用超脈遲二氧化碳點陣激光結閤中藥複春散治療.根據瘢痕形成時間,將患者分為早期組、中期組、晚期組.早期組為瘢痕形成3週～3箇月患者,共35例;中期組為瘢痕形成時間大于3箇月且小于或等于6箇月患者,共25例;晚期組為3～15年陳舊性瘢痕患者,共3例.統計各組患者的激光治療次數;數字評價量錶(NRS)評定3組患者治療前及治療1、2、3次後的瘢痕疼痛彊度;溫哥華瘢痕評定量錶評定瘢痕情況,比較早期組、中期組患者在治療前及治療1、3、5次後的分值,晚期組患者隻觀察、不評分;治療前及治療3、5次後,拍攝3組患者治療區域瘢痕照片評價療效.對數據行t檢驗. 結果 早期組患者治療(4.8±1.1)次;中期組(7.7±2.1)次;晚期組中2例患者治療5次後終止治療,1例治療12次.治療1次後,早期組和中期組患者疼痛減輕明顯,NRS評分1～4分者由5例增至38例;治療2、3次後,1～4分者增加幅度不大.治療前和治療1次後,早期組、中期組患者瘢痕情況評分相近(t值分彆為0.641、0.082、P值均大于0.05);治療3、5次後,早期組患者的瘢痕情況評分分彆為(9.2±0.8)、(7.0±1.1)分,明顯低于中期組的(9.7±1.0)、(8.2±1.0)分(t值分彆為-1.993、-4.433,P＜0.05或P＜0.01).治療3次後,早期組、中期組患者總有效率分彆為88.6％ (31/35)、72.0％(18/25);治療5次後,早期組、中期組患者總有效率分彆為100.0％(35/35)、96.0％(24/25);治療5次後晚期組3例患者效果不明顯. 結論 燒傷後增生性瘢痕早期應用超脈遲二氧化碳點陣激光結閤中藥複春散治療,效果明確.
목적 탐토초맥충이양화탄점진격광결합중약복춘산치료소상후증생성반흔적림상효과. 방법 2012년2월-2014년6월,선택필자단위수치적63례소상후증생성반흔환자,채용초맥충이양화탄점진격광결합중약복춘산치료.근거반흔형성시간,장환자분위조기조、중기조、만기조.조기조위반흔형성3주～3개월환자,공35례;중기조위반흔형성시간대우3개월차소우혹등우6개월환자,공25례;만기조위3～15년진구성반흔환자,공3례.통계각조환자적격광치료차수;수자평개량표(NRS)평정3조환자치료전급치료1、2、3차후적반흔동통강도;온가화반흔평정량표평정반흔정황,비교조기조、중기조환자재치료전급치료1、3、5차후적분치,만기조환자지관찰、불평분;치료전급치료3、5차후,박섭3조환자치료구역반흔조편평개료효.대수거행t검험. 결과 조기조환자치료(4.8±1.1)차;중기조(7.7±2.1)차;만기조중2례환자치료5차후종지치료,1례치료12차.치료1차후,조기조화중기조환자동통감경명현,NRS평분1～4분자유5례증지38례;치료2、3차후,1～4분자증가폭도불대.치료전화치료1차후,조기조、중기조환자반흔정황평분상근(t치분별위0.641、0.082、P치균대우0.05);치료3、5차후,조기조환자적반흔정황평분분별위(9.2±0.8)、(7.0±1.1)분,명현저우중기조적(9.7±1.0)、(8.2±1.0)분(t치분별위-1.993、-4.433,P＜0.05혹P＜0.01).치료3차후,조기조、중기조환자총유효솔분별위88.6％ (31/35)、72.0％(18/25);치료5차후,조기조、중기조환자총유효솔분별위100.0％(35/35)、96.0％(24/25);치료5차후만기조3례환자효과불명현. 결론 소상후증생성반흔조기응용초맥충이양화탄점진격광결합중약복춘산치료,효과명학.
Objective To explore the clinical effects of lattice ultra pulse carbon dioxide laser combined with traditional Chinese medicine (Fuchunsan) on the treatment of postburn hyperplastic scar.Methods Sixty-three patients with hyperplastic scar after burn injury hospitalized from February 2012 to June 2014 in our department were treated with lattice ultra pulse carbon dioxide laser combined with traditional Chinese medicine (Fuchunsan).Patients were divided into early stage group (E,n =35),middle stage group (M,n =25),and late stage group (L,n =3) according to the formation time of scar,which was respectively 3 weeks to 3 months,longer than 3 months and less than or equal to 6 months,and 3 to 15 years in groups E,M,and L.The number of times of laser treatment of patients in each group was recorded.The degree of scar pain in patients of the three groups was assessed by the Numerical Rating Scale (NRS) before treatment and after treatment for 1,2,and 3 times.The scar condition of patients in groups E and M was assessed by the Vancouver Scar Scale (VSS) before treatment and after treatment for 1,3,and 5 times.Patients in group L did not receive VSS assessment but were evaluated by clinical observation only.Photos of scar in treating area were taken before treatment and after treatment for 3 and 5 times to evaluate the clinical effect.Data were processed with t test.Results Patients in groups E and M were treated with laser for (4.8 ± 1.1) and (7.7 ±2.1) times respectively.In group L,the treatment was stopped in 2 patients after laser treatment for 5 times,and 1 patient received laser treatment for 12 times.The degree of pain in patients of groups E and M was alleviated significantly after treatment for one time,and the number of patients scoring 1-4 point (s) in NRS increased from 5 cases to 38 cases.After treatment for 2 and 3 times,the increase in the number of patients scoring l-4 point (s) in NRS was on a small scale.Before treatment and after treatment for 1 time,VSS scores of patients in groups E and M were similar (with t values respectively 0.641 and 0.082,P values above 0.05).After treatment for 3 and 5 times,VSS scores of patients in group E were respectively (9.2 ± 0.8) and (7.0 ± 1.1) points,which were significantly lower than those in group M [(9.7±1.0) and (8.2 ± 1.0) points,witht values respectively-1.993 and-4.433,P ＜0.05 or P ＜0.01].After treatment for 3 times,the rate of improvement in appearance was respectively 88.6％ (31/35) and 72.0％ (18/25) in groups E and M,and it was respectively 100.0％ (35/35) and 96.0％ (24/25) after treatment for 5 times.No significant effect in appearance was found in the 3 patients in group L.Conclusions Early application of lattice ultra pulse carbon dioxide laser combined with traditional Chinese medicine (Fuchunsan) for the treatment of postburn hyperplastic scar is effective.
