不同参数1565 nm非剥脱点阵激光治疗增生性瘢痕的疗效

doi:10.3760/cma.j.cn441417-20240805-12028

国际医药卫生导报 ›› 2025, Vol. 31 ›› Issue (12): 2073-2077.DOI: 10.3760/cma.j.cn441417-20240805-12028

不同参数1565 nm非剥脱点阵激光治疗增生性瘢痕的疗效

马彬溪¹ 王应权¹ 马云云² 朱振来³

¹西安交通大学第一附属医院榆林医院皮肤科，榆林 719000；²西电集团医院皮肤科，西安 710077；³中国人民解放军空军军医大学口腔科，西安 710038

收稿日期:2024-08-05 出版日期:2025-06-15 发布日期:2025-06-17
通讯作者: 马云云，Email：mayunyun1987@163.com
基金资助:
陕西省自然科学基础研究计划（2024JC-YBMS-645）

The efficacy of 1565 nm non-ablative fractional laser treatment with different parametexs for hypertrophic scars

Ma Binxi¹， Wang Yingquan¹， Ma Yunyun²， Zhu Zhenlai³

¹Department of Dermatology, Yulin Hospital, First Affiliated Hospital of Xi'an Jiaotong University, Yulin 719000, China; ²Department of Dermatology, Xidian Group Hospital, Xi'an 710077, China; ³Department of Stomatology, Air Force Medical University, Xi'an 710038, China

Received:2024-08-05 Online:2025-06-15 Published:2025-06-17
Contact: Ma Yunyun, Email：mayunyun1987@163.com
Supported by:
Shaanxi Provincial Natural Science Basic Research Program(2024JC-YBMS-645)

摘要/Abstract

摘要：

目的　探讨不同参数1 565 nm非剥脱点阵激光治疗增生性瘢痕的疗效及对生长因子的影响。方法　采用前瞻性随机对照试验。选取2020年5月至2023年6月西安交通大学第一附属医院榆林医院收治的62例增生性瘢痕患者，按随机数字表法分为A组和B两组，各31例。两组均使用非剥脱点阵激光治疗，仪器波长1 565 nm。A组男15例，女16例；激光参数设置能量30 mJ、密度 200 spots/cm²；年龄（25.85±4.54）岁，病程（2.98±1.36）年。B组男16例，女15例；激光参数设置能量45 mJ、密度200 spots/cm；年龄（26.52±4.18）岁，病程（3.02±1.30）年。两组患者均每月治疗1次，连续治疗3次。比较两组临床指标、治疗前后瘢痕评分、血清生长因子水平以及不良反应发生率。采用t检验、χ2检验进行统计学分析。结果　治疗后，A、B两组水肿消退时间和红斑消退时间分别为［（2.59±0.48）d比（2.72±0.43）d、（4.72±1.25）d比（5.07±1.29）d］，差异无统计学意义（P>0.05）；B组温哥华瘢痕评估量表（VSS）、观察者瘢痕评估量表（OSAS）、患者瘢痕评估量表（PSAS）评分均低于A组［（3.42±0.74）分比（4.31±0.82）分、（21.46±3.62）分比（24.68±3.47）分、（19.36±3.21）分比（21.75±3.13）分］，差异均有统计学意义（t=4.486、3.575、2.968，均P<0.05）。B组血管内皮生长因子（VEGF）、表皮生长因子（EGF）、转化生长因子-βl（TGF-βl）水平均低于A组［（185.43±51.64）ng/L比（212.96±52.83）ng/L、（179.35±49.71）ng/L比（205.35±50.24）ng/L、（243.21±48.78）ng/L比（275.64±52.46）ng/L］，差异均有统计学意义（t=2.075、2.048、2.521，均P<0.05）。A组随访期间并发症总发生率低于B组［3.23%（1/31）比6.45%（2/31）］，差异无统计学意义（P>0.05）。结论　1 565 nm非剥脱点阵激光在治疗增生性瘢痕方面具有显著疗效，高能量（45 mJ）治疗组的瘢痕评分（包括OSAS和PSAS评分）以及血清生长因子（VEGF、EGF、TGF-β1）水平方面均明显低于低能量（30 mJ）治疗组，且不良反应发生无显著差异。因此，高能量设置的1 565 nm非剥脱点阵激光可作为增生性瘢痕治疗的有效选择。

关键词: 增生性瘢痕, 1565 nm非剥脱点阵激光, 生长因子

Abstract:

Objective To investigate the efficacy of 1 565 nm non-ablative fractional laser treatment with different parameters on hypertrophic scars and its impact on growth factors. Methods A prospective study was conducted from May 2020 to June 2023 involving 62 patients with hypertrophic scars treated at Yulin Hospital, First Affiliated Hospital of Xi'an Jiaotong University. The patients were divided into two groups using a random number table method. In Group A, there were 15 males and 16 females; the laser parameters were set as follows: energy 30 mJ and density 200 spots/cm²;the age was (25.85±4.54) years old, and the disease duration was (2.98±1.36) years. In Group B, there were 16 males and 15 females;the laser parameters were set as follows: energy 45 mJ and density 200 spots/cm;the age was (26.52±4.18) years old, and the disease duration was (3.02±1.30) years. Both groups were treated once a month for three consecutive months. The clinical indicators, scar scores before and after treatment, serum growth factor levels, and adverse reaction rates were compared between the two groups. Statistical analysis was performed using t-tests and χ² tests. Results After treatment, there were no statistically significant differences in the times for edema and erythema resolution between the two groups [(2.59 ± 0.48) d vs. (2.72 ± 0.43) d and (4.72 ± 1.25) d vs. (5.07 ± 1.29) d], with no statistically significant differences (both P > 0.05). However, the Vancouver Scar Scale (VSS), Observer Scar Assessment Scale (OSAS), and Patient Scar Assessment Scale (PSAS) scores were significantly lower in Group B compared to Group A [(3.42 ± 0.74) points vs. (4.31 ± 0.82) points, (21.46 ± 3.62) points vs. (24.68 ± 3.47) points, and (19.36 ± 3.21) points vs. (21.75 ± 3.13) points, respectively, with t-values of 4.486, 3.575, and 2.968, all P < 0.05]. The post-treatment serum levels of vascular endothelial growth factor (VEGF), epidermal growth factor (EGF), and transforming growth factor-β1 (TGF-β1) were lower in Group B than in Group A [(185.43 ± 51.64) ng/L vs. (212.96 ± 52.83) ng/L, (179.35 ± 49.71) ng/L vs. (205.35 ± 50.24) ng/L, and (243.21 ± 48.78) ng/L vs. (275.64 ± 52.46) ng/L], with statistically significant differences (t = 2.075, 2.048, and 2.521, all P < 0.05). There were no statistically significant differences in the incidence rate of adverse reactions such as skin itching, pigmentation, and blisters [96.77% (30/31) vs. 93.55% (29/31), P > 0.05]. Conclusions The 1 565 nm non-ablative fractional laser is highly effective in treating hypertrophic scars. The scar scores (including OSAS and PSAS scores) and serum growth factor (VEGF, EGF, and TGF-β1) levels in the high-energy (45 mJ) treatment group were significantly lower than those in the low-energy (30 mJ) treatment group. Therefore, the high-energy setting of the 1 565 nm non-ablative fractional laser can be an effective choice for treating hypertrophic scars.

Key words: Hypertrophic scars, , 1 565 nm non-ablative fractional laser, , Growth factors

马彬溪王应权马云云朱振来. 不同参数1565 nm非剥脱点阵激光治疗增生性瘢痕的疗效 [J]. 国际医药卫生导报, 2025, 31(12): 2073-2077.

Ma Binx, Wang Yingqua, Ma Yunyu, Zhu Zhenlai.

The efficacy of 1565 nm non-ablative fractional laser treatment with different parametexs for hypertrophic scars [J]. International Medicine and Health Guidance News, 2025, 31(12): 2073-2077.

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不同参数1565 nm非剥脱点阵激光治疗增生性瘢痕的疗效

The efficacy of 1565 nm non-ablative fractional laser treatment with different parametexs for hypertrophic scars

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