染料脉冲光联合曲安奈德治疗瘢痕疙瘩的临床疗效评估

Clinical Efficacy Evaluation of Pulsed Dye Laser Combined with Triamcinolone Acetonide in the Treatment of Keloids

摘要: 目的：探讨染料脉冲光联合曲安奈德应用于瘢痕疙瘩的临床效果。方法：纳入28例2022年3月至2024年12月南昌大学第一附属医院瘢痕整形门诊就诊患者。对照组患者仅接受曲安奈德局部注射治疗，每4周一次，共计3次；观察组患者则在曲安奈德注射基础上联合DPL治疗，同样每4周进行一次联合治疗，共3次。评估过程采用盲法，由两名不参与分组及干预操作的研究人员使用患者与观察者瘢痕评估量表(POSAS)、视觉模拟量表(VAS)及瘢痕疙瘩患者生活质量调查量表进行分析，比较不同治疗方案的临床疗效。结果：对比患者基准表现，6个月随访时得到的患者POSAS评分、患者自评分及观察者评分改善显着。POSAS观察者得分，观察组的评分20.5 ± 2.5，对照组评分24.79 ±3.2分，(P < 0.05)。其中观察组的生活质量量表得分为(14.29 ± 5.04)分，而对照组为(19.07 ± 4.14)分，在症状缓解方面，联合治疗组显示出更持久地缓解瘙痒和疼痛的效果。结论：DPL联合曲安奈德治疗方案在改善瘢痕疙瘩方面的效果优于单一曲安奈德注射，且在缓解瘙痒、疼痛等症状方面具有更持久的优势。

Abstract: Objective: To evaluate the clinical efficacy of dual-wavelength pulsed dye laser (DPL) combined with intralesional triamcinolone acetonide (TAC) injection for keloid treatment. Methods: A total of 28 keloid patients treated between March 2022 and December 2024 were randomized into an observation group (DPL + TAC, n = 14) and a control group (TAC alone, n = 14). The control group received intralesional TAC injections every 4 weeks for 3 sessions, while the observation group received combined DPL and TAC therapy at the same intervals. Two blinded assessors conducted follow-up evaluations using the Patient and Observer Scar Assessment Scale (POSAS), Visual Analogue Scale (VAS), and a keloid-specific quality of life questionnaire. Clinical outcomes and adverse reaction rates were analyzed. Results: At 6 months post-treatment, both groups showed significant reductions in total POSAS scores, patient-reported scores, and observer-reported scores compared to baseline. The observation group achieved lower total POSAS scores (14.29 ± 5.04) than the control group (19.07 ± 4.14), with greater improvements in psychological and physical dimensions. The combined therapy also demonstrated sustained relief of pruritus and pain. Conclusion: DPL combined with TAC is superior to TAC monotherapy in treating keloids, providing durable symptomatic relief and enhanced quality of life.