Abstract：
Objective: To analyze and compare the effect of the combination of energy and density parameters of CO2 dot matrix laser in the hyperplastic stage of pediatric burn. Materials and Methods: A total of 160 pediatric patients with hypertrophic scar after limb burn from 2017 to 2020 were randomly divided into four parameter groups (n = 40). The patients were treated with ablative fraction carbon dioxide laser, once every 10 weeks. During the interval of laser treatment, Compound Heparin Sodium and Allantoin Gel (Contractubex) was applied externally, tid, and elastic cover or elastic bandage is attached to the affected limb. Scoring based on the Vancouver Scar Scale is performed before each laser treatment, The score before the first treatment was the initial score, which was scored by two people separately, and the average score was calculated. Subsequently, the patients were treated four times and scored. The differences between each treatment and the first score of each parameter group were compared. Under the same energy and different treatment density, the scores after each treatment were compared. Under the same density and different energy, the scores after each treatment were compared. The bleeding and pigmentation of each parameter group were compared. Results: The increase of density can show the therapeutic effect earlier than the increase of energy, and 25mj energy and 10% density have better intervention effect. With the course of disease and the progress of treatment, the correlation between intervention effect and parameters tends to weaken. Comparing the number of cases with different scores between each treatment and the first time, the score in the 5% density group was lower than that in the 10% density group, but there was no significant difference between the 25mj and 17.5mj energy levels in the same density group. The intervention effect of the increase of density on scar was better than that of energy, and the increase of energy and density could aggravate the pain. Conclusion: In pediatric burn hypertrophic scars treated by CO2 dot matrix laser in exfoliation mode, the intervention effect of increasing density is better than that of energy. When setting laser treatment parameters, we should give priority to increasing density and adjust energy according to the effect of treatment and the condition of pain, bleeding and color precipitation. In this study, the best combination of parameters is 17.5mj/10%.
摘要：
目的:分析比较CO2点阵激光联合能量和密度参数在小儿烧伤增生期的应用效果。材料与方法:将2017-2020年收治的160例四肢烧伤后增生性瘢痕患儿随机分为4个参数组(n=40)。患者接受了消融部分二氧化碳激光治疗，每10周一次。在激光治疗的间隔，外用复方肝素钠尿囊素凝胶(Contractubex),tid,和弹性覆盖物或弹性绷带连接到受影响的肢体。在每次激光治疗之前进行基于温哥华疤痕量表的评分，第一次治疗前的评分是初始评分，这是由两个人分别得分的，并计算平均得分。随后，患者接受了4次治疗并评分.比较各治疗方案与各参数组首次评分的差异。在相同的能量和不同的处理密度下，比较各治疗后的评分。在相同的密度和不同的能量下，比较各治疗后的评分。比较各参数组的出血和色素沉着情况。结果：密度的增加比能量的增加更早显示治疗效果，25mj能量和10%密度有较好的干预效果。随着病情的发展和治疗的进展,干预效果与参数之间的相关性趋于减弱。比较每次治疗与第一次治疗不同评分的病例数,5%密度组的得分低于10%密度组，但是在相同密度组中，25mj和17.5mj的能量水平之间没有显着差异。密度增加对瘢痕的干预效果优于能量，能量和密度的增加会加重疼痛。结论:CO2点阵激光治疗小儿烧伤增生性瘢痕,增加密度的干预效果优于能量的干预效果。设置激光治疗参数时，我们应该优先增加密度，根据治疗效果和疼痛情况调整能量，出血和颜色沉淀。在这项研究中,最佳参数组合为17.5mj/10%。
