中国口腔颌面外科杂志

中国口腔颌面外科杂志 ›› 2025, Vol. 23 ›› Issue (1): 62-66.doi: 10.19438/j.cjoms.2025.01.011

• 论著 • 上一篇    下一篇

A型肉毒素联合脉冲染料激光预防颌面部手术切口瘢痕增生的效果观察

马成1, 张艳2, 马旭3   

  1. 1.中国人民解放军联勤保障部队第904医院 口腔科,江苏 无锡 214000;
    2.无锡市公安局卫生所,江苏 无锡 214000;
    3.无锡市中医医院 检验科,江苏 无锡 214071
  • 收稿日期:2024-05-28 修回日期:2024-08-16 出版日期:2025-01-20 发布日期:2025-01-23
  • 通讯作者: 马旭,E-mail: 13915371326@163.com
  • 作者简介:马成（1993-）,男,本科,主治医师,E-mail: 13921500127@163.com

The effect of botox A combined with pulsed dye laser on preventing scar hyperplasia after maxillofacial surgery

MA Cheng1, ZHANG Yan2, MA Xu3   

  1. 1. Department of Stomatology, The 904 Hospital of the Joint Logistic Support Force of PLA. Wuxi 214000;
    2. Wuxi Public Security Bureau Health Institute. Wuxi 214000;
    3. Clinical Laboratory, Wuxi Hospital of Traditional Chinese Medicine. Wuxi 214071, Jiangsu Province, China
  • Received:2024-05-28 Revised:2024-08-16 Online:2025-01-20 Published:2025-01-23

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摘要： 目的：探讨A型肉毒素联合脉冲染料激光预防颌面部手术切口瘢痕增生的效果。方法：选择2019年8月—2022年12月联勤保障部队第904医院口腔科收治的接受颌面部手术的患者92例,采用随机数字表法分为试验组（n=46）和对照组（n=46）。试验组采用A型肉毒素联合脉冲染料激光（pulsed dye laser,PDL）预防手术切口瘢痕增生,对照组仅采用A型肉毒素。比较2组患者的临床疗效、瘢痕情况、患者满意度及不良反应。采用SPSS 22.0软件包对数据进行统计学分析。结果：试验组临床总有效率为84.78%,显著高于对照组的63.04%（P<0.05）。2组治疗前瘢痕颜色、平整度、弹性程度、瘢痕宽度评分等无统计学差异（P>0.05）,2组治疗完成1周后瘢痕颜色、平整度、弹性程度、瘢痕宽度评分均显著低于治疗前,且试验组显著低于对照组（P<0.05）。试验组总体满意度显著高于对照组（P<0.05）。试验组与对照组减张缝合情况、伤口位于瘢痕增生好发部位情况与存在瘢痕张力情况比较,差异无统计学意义（P>0.05）。2组治疗后不良反应发生率无统计学差异（P>0.05）。结论：A型肉毒素联合脉冲染料激光预防颌面部手术切口瘢痕增生的效果较好,安全性高,可在临床上推广使用。

关键词: A型肉毒素, 脉冲染料激光, 颌面部手术, 瘢痕增生, POSAS评分

Abstract: PURPOSE: To investigate the effect of botulinum toxin A combined with pulsed dye laser on preventing scar hyperplasia in maxillofacial surgical incisions. METHODS: A total of 92 patients receiving maxillofacial surgery at the Department of Stomatology of 904 Hospital of the Joint Logistic Support Force of PLA from August 2019 to December 2022 were selected and divided into the experimental group(n=46) and the control group(n=46) by random number table method. Pulsed dye laser (PDL) combined with botox type A was used in the experimental group to prevent scar hyperplasia of surgical incision, while botox type A alone was used in the control group. The clinical efficacy, scar status, patient satisfaction and adverse reactions were compared between the two groups. SPSS 22.0 software package was used for data analysis. RESULTS: The total effective rate of the experimental group was 84.78%, which was significantly higher than that of the control group(63.04%, P<0.05). There were no significant differences in scar color, flatness, elasticity and scar width scores between the two groups before treatment(P>0.05). After 1 week of treatment, scar color, flatness, elasticity and scar width scores between the two groups were significantly lower than before treatment, and the experimental group was significantly lower than the control group (P<0.05). The total satisfaction of the experimental group was significantly higher than that of the control group(P<0.05). There was no significant difference between the experimental group and the control group in the situation of detensioning suture, the location of the wound at the prone site of scar hyperplasia and the presence of scar tension (P>0.05). There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05). CONCLUSIONS: The combination of type A botulinum toxin and pulsed dye laser has a good effect and high safety in preventing scar hyperplasia in maxillofacial surgical incisions, and can be widely used in clinical practice.

Key words: Type A botulinum toxin, Pulsed dye laser, Maxillofacial surgery, Scar hyperplasia, POSAS rating

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