组织工程与重建外科杂志 ›› 2025, Vol. 21 ›› Issue (2): 178-.

• • 上一篇    下一篇

体外冲击波联合超声改善瘢痕凹陷粘连的治疗效果观察

  

  • 出版日期:2025-04-01 发布日期:2025-05-13

Observation of the therapeutic effect of extracorporeal shock wave therapy combined with ultrasound in ameliorating scar  indentation and adhesion

  • Online:2025-04-01 Published:2025-05-13

摘要: 目的 观察体外冲击波联合超声治疗改善瘢痕凹陷粘连的效果。方法 回顾性分析2023年1—12月于我科 就诊的46例瘢痕凹陷粘连的患者资料,所有患者均为损伤后瘢痕愈合存在动态凹陷,于我科行保守瘢痕康复治疗。以 是否接受体外冲击波治疗作为分组依据,分为对照组和试验组,对照组采用传统超声改善瘢痕粘连,试验组在超声治疗 的基础上配合使用冲击波治疗。分别收集治疗前、治疗后 2周、治疗后 4周、治疗后 8周时,使用 14 MHz高频超声采集 患者的瘢痕皮肤声像图及瘢痕厚度数据;邵氏硬度计评估各组患者的瘢痕硬度;调查治疗后患者的最终满意度,并记录 不良事件。结果 治疗2周、4周及8周后,对照组和试验组B超示:前后径(瘢痕厚度)数值变小,试验组数值减小更明 显(P<0.05)。治疗2周、4周及8周后,硬度计测量显示对照组和试验组硬度均变小,各时间点试验组硬度均明显小于 对照组(P<0.05)。治疗2个月后,试验组患者满意度评分明显高于对照组(P<0.05)。两组患者血肿、疼痛发生率无统 计学差异(P>0.05)。结论 瘢痕凹陷粘连通过体外冲击波周期性治疗,可在瘢痕超声治疗的基础上有效减少瘢痕厚 度,改善瘢痕硬度,明显提高患者及家属的治疗满意度,值得在瘢痕凹陷粘连的临床治疗中推广。

关键词: 瘢痕粘连,  体外冲击波治疗,  动态凹陷

Abstract: Objective To observe the effect of extracorporeal shock wave therapy (ESWT) combined with ultrasound on the improvement of scar indentation and adhesion. Methods A retrospective analysis was conducted on the clinical data of 46 patients with scar depression and adhesion who were treated at our department from January 2023 to December 2023. All patients had dynamic depression of the scar after wound healing and underwent conservative scar rehabilitation treatment at our department. According to whether ESWT was received or not, the patients were divided into control group and experimental group. The control group was treated with traditional ultrasound to improve scar adhesion, and the experimental group was treated with ESWT on the basis of ultrasound therapy. The patients’ scar skin images and thickness data were collected using a 14 MHz high-frequency ultrasound before and after treatment for 2 weeks, 4 weeks, 8 weeks, respectively. The Shore hardness meter was used to evaluate the hardness of the scars in each group, and the patients’ satisfaction with the treatment was recorded, along with any adverse events. Results After 2 weeks, 4 weeks, and 8 weeks of treatment, the Bultrasound showed that the anterior-posterior diameter (scar thickness) of the control group and the experimental group decreased, and the change in the experimental group was more obvious (P<0.05). After 2 weeks, 4 weeks, and 8 weeks of treatment, the hardness measured by the hardness meter in both groups showed a decrease in hardness, and the hardness of the scar in the experimental group was significantly lower than that of the control group at each time point (P<0.05). After 2 months of treatment, the satisfaction score of experimental group was significantly higher than that of control group( P<0.05). There was no significant difference in the incidence of hematoma and pain between the two groups (P>0.05). Conclusion  ESWT treatment can effectively reduce scar thickness and improve scar hardness on the basis of ultrasound treatment, and significantly improve the treatment satisfaction of patients and their families, which is worthy of promotion in the clinical treatment of scar depression and adhesion. 

Key words: Scar adhesion,  Extracorporeal shock wave therapy,  Dynamic depression