中频电治疗烧伤后增生性瘢痕的临床疗效观察

Effect of medium frequency electrotherapy on hypertrophic scar

  • 摘要:
      背景  中频电治疗联合超声、药物等可有效防治瘢痕增生、软化瘢痕,但中频电治疗增生性瘢痕缺乏系统性、客观性的研究。
      目的  观察中频电治疗烧伤后增生性瘢痕的临床疗效。
      方法  选取2017年6月- 2019年6月西南医科大学附属医院整形烧伤外科收治的30例增生性瘢痕患者,按随机抽样法分为对照组和观察组,每组各15例。对照组采用常规防疤治疗,擦涂硅酮药物、瘢痕贴;观察组采用常规防疤治疗和中频电治疗。分别于1个月、3个月和6个月时使用20 MHz高频超声采集患者瘢痕的皮肤声像图并检测皮肤全层厚度,使用邵氏硬度计检测瘢痕软度,温哥华瘢痕量表(Vancouver scar scale,VSS)评定各组受试者的瘢痕情况,并通过视觉模拟评分(visual analogue scale,VAS)观察受试者瘢痕瘙痒情况。
      结果  1个月时两组瘢痕厚度均较薄,表皮较平整,在表皮下层和真皮上层间均出现一条低回声带;而在3个月和6个月时两组瘢痕均明显增厚(P<0.025),表皮不平整,向上隆起,且出现真皮全层的低回声区域或无回声区域。两组3个月与6个月时瘢痕的硬度、VSS评分和瘙痒VAS评分均明显高于1个月时(P<0.025),各时间点观察组瘢痕硬度和对照组差异无统计学意义(P>0.05),3个月时观察组VSS评分明显低于对照组(P<0.05),各时间点观察组的VAS评分均低于对照组(P<0.05)。
      结论  中频电治疗虽不能有效抑制早期瘢痕增生,但可软化增生性瘢痕,并明显减轻瘢痕瘙痒,改善瘢痕情况。

     

    Abstract:
      Background  Medium frequency therapy combined with ultrasound and drugs can effectively prevent and treat hypertrophic scar and soften scar, but there is a lack of systematic and objective research on the treatment of hypertrophic scar by medium frequency therapy.
      Objective  To observe the clinical effect of medium frequency electrotherapy on hypertrophic scar after burn.
      Methods  Thirty patients with hypertrophic scar treated in the Department of Plastic and Burn Surgery of the Affiliated Hospital of Southwest Medical University from June 2017 to June 2019 were randomly divided into control group and observation group, with 15 cases in each group. The patients in the control group were treated with conventional anti scar therapy, rubbed with silicone medicine and scar patch, while the patients in the observation group were treated with conventional anti scar therapy and medium frequency electric therapy. The 20 MHz high-frequency ultrasound was used to collect the skin ultrasonogram of the volunteers' scars and detect the full-thickness of the skin. The hardness of the scars was measured by shore hardness tester. The Vancouver Scar Scale (VSS) was used to evaluate the scar condition, and the scar itching was observed by visual analogue scale (VAS). All the above tests were performed at 1, 3 and 6 months after treatment.
      Results  At 1 month after treatment, the scar thickness of the two groups were thin, with smooth epidermis, and there was a low echo zone between the lower epidermis and the upper dermis; while the scars were significantly thickened at 3 and 6 months after treatment (P<0.025), with uneven and uplifted epidermis, and there was a hypoechoic area or anechoic area of the whole dermis. At the same time, the scar hardness, VSS score and pruritus VAS score of the both groups at 3 and 6 months were significantly higher than those at 1 month after treatment (P<0.025), and there was no significant difference in scar hardness between the observation group and the control group at all time points (P>0.05), but the VSS score of the observation group was significantly lower than that of the control group at 3 months after treatment (P<0.05), VAS score of the observation group at all time points was lower than that of the control group (P<0.05).
      Conclusion  Although medium frequency electric therapy cannot effectively inhibit scar hyperplasia, it can soften hypertrophic scar, significantly relieve scar itching and improve scar condition in patients.

     

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