组织工程与重建外科杂志

组织工程与重建外科杂志 ›› 2023, Vol. 19 ›› Issue (5): 454-.

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儿童手指挛缩性瘢痕激光治疗体会

  

  • 出版日期:2023-10-09 发布日期:2023-11-01

Experience of laser treatment of finger contracture scars in children

  • Online:2023-10-09 Published:2023-11-01

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摘要：

目的　探讨小儿手指挛缩性瘢痕激光治疗经验。

方法　采用自身前后对照研究方法，选取 2021 年 12 月至2022 年 12 月，昆明市儿童医院皮肤科收治的 30 例手指挛缩性瘢痕患儿。其中 17 例瘢痕外观色红、充血明显，使用脉冲染料激光（PDL，585 nm）联合超脉冲 CO2 点阵激光进行治疗 ；13 例肤色瘢痕单独使用超脉冲 CO2 点阵激光进行治疗。每例患儿治疗 3 次，每次治疗间隔 2 个月。治疗前、治疗后分别采用温哥华瘢痕评分量表（VSS）对瘢痕情况进行评分，并记录治疗前后受累关节活动度的变化以及不良反应发生情况，治疗结束 8 周后进行疗效评价。结果　所有病例治疗后与治疗前相比，VSS 评分均明显下降（P<0.05），受累关节活动度明显优于首次治疗前（P<0.05）。疗效评价结果显示，显效 19 例、有效 8 例、无效 3 例，显效率 63.3%，有效率 90.0%。治疗区域治疗后均未观察到水疱、感染、增生性瘢痕形成等不良反应。

结论　激光治疗小儿手指挛缩性瘢痕效果明显，相关并发症少，值得临床推广。

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Abstract:

Objective　To explore the experience of laser treatment for finger contracture scars in children. Methods　A
retrospective before-after self-control study was conducted. Thirty patients with finger contracture scars from December 2021
to December 2022 were admitted. Among them, 17 cases of scars with red appearance and obvious congestion were treated with
pulsed dye laser (PDL, 585 nm) combined with ultra pulse carbon dioxide lattice laser, while 13 cases of skin scars were treated
with ultra pulse carbon dioxide lattice laser alone. Each patient was treated three times, with a 2-month interval between each
treatment. Before and after treatment, the Vancouver Scar Scale (VSS) was used to score the scar condition, and the changes in
the range of motion of the affected joint before and after treatment, as well as the occurrence of adverse reactions, were recorded.
The efficacy was evaluated 8 weeks after the end of treatment. Results　After treatment, the VSS score of all cases decreased
significantly compared to before treatment (P<0.05), the range of motion of the affected joint was significantly higher than before
the first treatment (P<0.05). The efficacy evaluation results showed that there were 19 cases of significant improvement, 8 cases
of effective treatment, and 3 cases of ineffective treatment, with a significant improvement rate of 63.3% and an effective rate of
90.0%. No adverse reactions such as blisters, infections, or hypertrophic scar formation were observed in the treatment area after
treatment. Conclusion　Laser treatment of finger contracture scar in children has obvious effect and less related complications,
which is worthy of clinical promotion.

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