可调脉宽倍频Nd:YAG激光和点阵CO2激光综合治疗瘢痕的临床应用(1)
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[摘要]目的：探讨综合应用可调脉宽倍频Nd：YAG532nm激光和点阵CO2激光分别治疗面颈部早期红色瘢痕和晚期浅表性瘢痕的临床效果。方法：采用可调脉宽倍频Nd:YAG 532nm波长激光治疗面颈部红色增生期瘢痕，采用点阵CO2激光治疗面颈部浅表性瘢痕，并且根据疗效评定标准对治疗效果进行评价。结果：98个早期红色增生期瘢痕每次经激光治疗后症状和体征都减轻，4次治疗后手术切口条形瘢痕的总有效率为100%，显效率为96%，挫伤及烧烫伤后片状瘢痕的总有效率为91%，显效率为70%。80例浅表性瘢痕一次治疗后的总显效率为65%。结论：综合应用可调脉宽倍频Nd：YAG532nm激光和点阵CO2激光分别治疗面颈部早期增生性瘢痕和晚期浅表性瘢痕的治疗方案可行，值得临床推广应用。
[关键词]激光；瘢痕；疗效
[中图分类号]R619+.9[文献标识码]A[文章编号]1008-6455(2011)03-0443-03
Clinical observation of treatingscars with variable pulsed Nd:YAGlaser and fractional CO2 laser
TAN Jun,LI Gao-feng,ZHONG Qian,ZOU Bo-sheng,ZHU Yi,WU Dong-hui,LUO Tao,LI Bo,DING Wei
(Department of Plastic and Cosmetic Surgery, The First Affiliated Hospital of Hunan Normal University,Changsha 410005, Hunan ,China)
Abstract： Objective To evaluate the curative effect of the treatment protocol of combination variable pulsed Nd:YAG 532 nm laser treating red scars in inchoate stage and fractional CO2 laser treating superficial scars in late stage.Methods The variable pulsed Nd:YAG 532 nm laser was used to treat inchoate red scars in the face and neck，and the ActiveFXUltraPulse Encore fractional CO2 laser was used to treat late superficial scars. The curative rates were evaluated. Results90 patients with 98 sites of red scars were involved The sings and symptoms of red scars were relieved afer treatment.The effective rate and curative rate afer treatment for 4 times were 100% and 96% to the strip scar，91% and 70% to the lamellar scar respectively.80 patients withsuperficial scars were involved.The total curative rate after one time treatment was 65%.Conclusion The treatment protocol of combination variable pulsed Nd:YAG 532 nm laser treating red scars in inchoate stage and fractional CO2 laser treating superficial scars in late stage is effective and worth to popularize.
Key words：laser;scar;curative effect
瘢痕的防治是整形外科每天要面对的问题，然而在非手术处理上一直缺乏良好的系统性措施。特别需要进行非手术性防治的瘢痕，主要可分为两大类：即早期的红色增生性瘢痕和晚期稳定的凹凸不平的浅表性瘢痕。早期红色增生性瘢痕增生迅速，需要积极阻止，晚期凹凸不平的浅表性瘢痕，明显影响外观，也需进行积极治疗。针对这两大类瘢痕，我们在临床上综合应用可调脉宽倍频Nd：YAG532nm激光和点阵CO2激光分别治疗面颈部早期增生性瘢痕和晚期浅表性瘢痕，取得良好疗效，现总结报道如下。
1资料和方法
1.1 一般资料：面颈部早期红色增生性瘢痕98个，共90例患者(其中男22例、女68例)，年龄8～48岁，病程1～3个月；手术切口条形瘢痕75个，挫伤及烧烫伤后片形瘢痕23个，条形瘢痕最短1cm，最长20cm，片形瘢痕最小1cm×1cm，最大2cm×5cm，瘢痕均呈鲜红、紫红或暗红色。面颈部浅表性瘢痕80例，其中男12例，女68例，年龄18～40岁，病程6月～20年 ......
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